A Comparative Study of Donor Site Morbidity between Patients with or without Iliac Donor Site Reconstruction after Anterior Thoracolumbar Spinal Fusion using Auto-Iliac Tricortical Strut done Graft
Authors
김형찬 ; 문성환 ; 이환모 ; 심동식
Citation
Journal of Korean Society of Spine Surgery (대한척추외과학회지), Vol.11(1) : 31-39, 2004
anterior thoracolumbar spinal fusion ; donor site morbidity ; bone cement ; iliac reconstruction
Abstract
Study Design
A comparative retrospective study between those who have and have not undergone donor site reconstruction after thoracolumbar spinal anterior interbody fusion using an auto-iliac bone graft.
Objectives
To determine the efficacy of iliac reconstruction in reducing iliac donor site morbidity.
Summary of Literature Review
An autogenous bone graft harvested from the iliac crest is still the gold standard for spinal anterior interbody fusion. However, defects of a significant size often remain in the donor site, which may cause pain, pelvic instability and cosmetic deformity etc. Iliac donor site reconstruction with bone cement is one of the methods for reducing the donor site morbidity, with a relatively easy technique.
Materials and Methods
A review of patients who underwent iliac bone graft harvesting, with or without reconstruction, by a single orthopaedic surgeon was conducted. The iliac donor site morbidity, at least one after remote surgery was compared in those who had and had not undergone iliac reconstruction. All patients were evaluated by an independent observer. During a two and half year period, 61 patients met the inclusion criteria. Twenty-three patients underwent iliac donor site reconstruction with bone cement and 9 with auto rib bone reconstruction, while the remaining 29 had no donor site reconstruction. Patients were asked to assess the duration and severity of their donor site pain, using a visual analogue scale (VAS), and other morbidity, such as cosmetic deformity.
Results
The severity of chronic donor site pain was significantly reduced in the donor site reconstruction group; however, there were no statistically significant differences, other than chronic pain, in the morbidities.
Conclusions
Iliac donor site reconstruction, with bone cement or auto-rib bone, is a relatively easy technique to perform after anterior spinal fusion. Better results can be expected, especially in reducing postoperative donor site pain.