Use of autologous bone graft in anterior cervical decompression: morbidity & quality of life analysis.
AffiliationDepartment of Surgery, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland. firstname.lastname@example.org
Delivery of Health Care
Outcome Assessment (Health Care)
Quality of Life
Spinal Cord Compression
Surgical Wound Infection
MetadataShow full item record
CitationUse of autologous bone graft in anterior cervical decompression: morbidity & quality of life analysis. 2009, 10:158 BMC Musculoskelet Disord
JournalBMC musculoskeletal disorders
AbstractBACKGROUND: Autologous iliac crest graft has long been the gold standard graft material used in cervical fusion. However its harvest has significant associated morbidity, including protracted postoperative pain scores at the harvest site. Thus its continued practice warrants scrutiny, particularly now that alternatives are available. Our aims were to assess incidence and nature of complications associated with iliac crest harvest when performed in the setting of Anterior Cervical Decompression (ACD). Also, to perform a comparative analysis of patient satisfaction and quality of life scores after ACD surgeries, when performed with and without iliac graft harvest. METHODS: All patients who underwent consecutive ACD procedures, with and without the use of autologous iliac crest graft, over a 48 month period were included (n = 53). Patients were assessed clinically at a minimum of 12 months postoperatively and administered 2 validated quality of life questionnaires: the SF-36 and Cervical Spine Outcomes Questionnaires (Response rate 96%). Primary composite endpoints included incidence of bone graft donor site morbidity, pain scores, operative duration, and quality of life scores. RESULTS: Patients who underwent iliac graft harvest experienced significant peri-operative donor site specific morbidity, including a high incidence of pain at the iliac crest (90%), iliac wound infection (7%), a jejunal perforation, and longer operative duration (285 minutes vs. 238 minutes, p = 0.026). Longer term follow-up demonstrated protracted postoperative pain at the harvest site and significantly lower mental health scores on both quality of life instruments, for those patients who underwent autologous graft harvest CONCLUSION: ACD with iliac crest graft harvest is associated with significant iliac crest donor site morbidity and lower quality of life at greater than 12 months post operatively. This is now avoidable by using alternatives to autologous bone without compromising clinical or technical outcome.
CollectionsJournal articles & published research
- Iliac crest bone graft donor site pain after anterior lumbar interbody fusion: a prospective patient satisfaction outcome assessment.
- Authors: Sasso RC, LeHuec JC, Shaffrey C, Spine Interbody Research Group.
- Issue date: 2005 Feb
- Prospective evaluation of chronic pain associated with posterior autologous iliac crest bone graft harvest and its effect on postoperative outcome.
- Authors: Schwartz CE, Martha JF, Kowalski P, Wang DA, Bode R, Li L, Kim DH
- Issue date: 2009 May 29
- Prospective study of iliac crest bone graft harvest site pain and morbidity.
- Authors: Kim DH, Rhim R, Li L, Martha J, Swaim BH, Banco RJ, Jenis LG, Tromanhauser SG
- Issue date: 2009 Nov
- Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion.
- Authors: Silber JS, Anderson DG, Daffner SD, Brislin BT, Leland JM, Hilibrand AS, Vaccaro AR, Albert TJ
- Issue date: 2003 Jan 15
- Iliac crest reconstruction to reduce donor-site morbidity: technical note.
- Authors: Dusseldorp JR, Mobbs RJ
- Issue date: 2009 Sep