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Shin, Cho, Han, Kim, and Lee: Reconstruction of Iliac Crest Donor Site Using 1/3 Tubular Plate
Original Research

Journal of Korean Spine Surg 2006;13(2):87-92.

Published online: 18 January 2006

DOI: https://doi.org/10.7469/JKSS.2006.13.2.87

Reconstruction of Iliac Crest Donor Site Using 1/3 Tubular Plate

Dong Eun Shin, M.D., Duck Yun Cho, M.D., Soo Hong Han, M.D., Jae-Hwa Kim, M.D., Soon Chul Lee, M.D.

Department of Orthopaedic Surgery, Bundang CHA Hospital, College of Medicine, Pochon CHA University, Sung-Nam, Korea

Address reprint requests to Soo Hong Han, M.D. Department of Orthopaedic Surgery, Bundang CHA Hospital, College of Medicine, Pochon CHA University 351 Yatap-dong, Bundang-gu, Sungnam-si, Kyonggi-do, 463-712, Korea Tel: 82-31-780-5289, Fax: 82-31-708-3578, E-mail: shinde@cha.ac.kr

∗ 본 논문의 요지는 2005년도 대한척추외과학회 춘계학술대회에서 발표되었음.

Copyright © 2006 Korean Society of Spine Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study design

This is a prospective study Objectives: The purpose of this study is to describe the technique for reconstruction of the iliac crest graft donor site and to determine the clinical results of its application.

Summary of Literature Review

An iliac crest tricortical bone graft is frequently used for anterior interbody fusion of the spine. For preventing iliac crest graft donor site morbidity (pain, skin dimpling, etc), various graft materials have been used, for exam-ple, rib, cement, ceramic and so on. However, the rib needs another incision for lumbar or cervical fusion, the cement sometimes causes the wound infection, and the bioactive ceramic spacer has not had its long term results confirmed.

Materials and Methods

We prospectively analyzed 28 patients who underwent iliac crest reconstruction with a 1/3 tubular plate after bone harvesting between 1998 and 2004. Pain at postoperative 1 month, 6 months and 1 year was checked by the visual analogue scale (VAS). The cosmetic appearance, foreign body sense, overall satisfaction (according to the methods of Ito et al), complications and the radiologic evaluations were all analyzed as indicators of the outcome.

Results

The mean visual analogue scale was 3.5 and 0.1 at postoperative 1 and 12 months, respectively. For the cosmetic appearance, among the 28 patients, 24 patients felt a smooth and satisfactory outline (Excellent). 25 patients couldn't feel any foreign body sense. One patient experienced wound infection. No plate breakage or screw loosening were observed.

Conclusions

Reconstruction of the iliac crest with a one-third tubular plate after tricortical bone graft harvest could be a favor-able method. the screws during the consolidation of PMMA.

Keywords: Tricortical iliac bone graft, iliac crest reconstruction, 1/3 tubular plate

REFERENCES

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Fig. 1.
L-spine MRI, 38-year old male patient. (A) In the axial view, infectious spondylitis and discitis with paravertebral abcess is shown. (B) In the sagittal view, the prevertebral abcess and infectious spondylitis at L2 and L3 is seen
jkss-13-87f1.tif
Fig. 2.
Postoperative X-ray shows the pedicle screw instrumentation and the anterior interbody fusion with auto iliac bone graft from L1 to L4. (A) Anterior posterior view (B) Lateral view
jkss-13-87f2.tif
Fig. 3.
The iliac crest donor site is reconstructed by the 1/3 tubular plate.
jkss-13-87f3.tif
Table 1.
Clinical result
  Excellent Good Poor
Cosmetic appearancea 24 4 0
Foreign body senseb 25 2 1
Overall satisfactionc 22 5 1

a Excellent: smooth and satisfactory outline; good: some alteration of outline but generally satisfactory; poor: obvious irregular outline

b Excellent: none; good: slight or occasional; poor: some or more than occasional

c Excellent: satisfied; good: almost satisfied; poor: dissatisfied

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