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Research ArticleBiologics

Harvest of Iliac Crest Autograft Not Associated With Localized Pain

Joseph E. Snavely, Ronald W. Mercer and Geoffrey Stewart
International Journal of Spine Surgery July 2019, 6037; DOI: https://doi.org/10.14444/6037
Joseph E. Snavely
1Orlando Regional Medical Center, Orlando Health, Orlando, Florida,
MD
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Ronald W. Mercer
2Beth Israel Deaconess Medical Center, Harvard University, Boston, Massachusetts,
MD
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Geoffrey Stewart
3The Spine and Scoliosis Center, Orlando, Florida
MD
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ABSTRACT

Background There exists a wide variety of bone grafts, substitutes, and extenders, which are utilized in spinal arthrodesis surgery. While iliac crest autograft is the traditional gold standard for use in spinal arthrodesis, there is considerable discrepancy in the literature regarding its associated complications. Primarily among these is the perception that the procedure is painful and has a high infection rate. The purpose of this study is to determine if patients experience more pain postoperatively on the iliac crest autograft donor side of the pelvis than the contralateral side.

Methods This study was a retrospective chart analysis of prospectively collected data on 76 patients who underwent elective lumbar arthrodesis with iliac crest autograft performed by one surgeon. The patients filled out a pain diagram with a five-region visual analogue scale, including each iliac crest, at the preoperative and each postoperative visit. Patient-reported pain data at various time points was compared from donor and contralateral sides and analysis included trends over time. Additionally, complications were noted when they occurred. The surgical approach involved a midline skin incision in all patients with epifascial and subperiosteal dissection to the posterior superior iliac spine.

Results There were no significant differences in reported pain between donor and nondonor side. There was no significant main effect of side of measurement (P = .75) and no significant side by time of measurement interaction effect (P = .95). There was a significant main effect of time of measurement for both sides (P < .001). There were no cases of donor site complications.

Conclusions Iliac crest harvest and reconstruction utilizing this technique does not result in increased pain on the side of the harvest. This study supports a low morbidity rate for iliac crest autograft harvest as no complications were seen in this series.

Level of Evidence 3

  • iliac
  • crest
  • bone
  • graft
  • harvest
  • postoperative
  • morbidity
  • pain
  • donor
  • side
  • lumbar
  • arthrodesis
  • fusion
  • ICBG

Footnotes

  • Disclosures and COI: The authors declare no conflicts of interest. The study protocol was reviewed and approved by the University of Central Florida Institutional Review Board.

  • ©International Society for the Advancement of Spine Surgery
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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Harvest of Iliac Crest Autograft Not Associated With Localized Pain
Joseph E. Snavely, Ronald W. Mercer, Geoffrey Stewart
International Journal of Spine Surgery Jul 2019, 6037; DOI: 10.14444/6037

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Harvest of Iliac Crest Autograft Not Associated With Localized Pain
Joseph E. Snavely, Ronald W. Mercer, Geoffrey Stewart
International Journal of Spine Surgery Jul 2019, 6037; DOI: 10.14444/6037
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Keywords

  • iliac
  • crest
  • bone
  • graft
  • harvest
  • postoperative
  • morbidity
  • pain
  • donor
  • side
  • lumbar
  • arthrodesis
  • fusion
  • ICBG

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