Vascularized Posterior Iliac Crest Bone Grafting: Indications, Techniques, Clinical Outcomes, and Alternatives

Sebastian J. Winocour; Kelly P. Schultz; Matthew J. Davis; Amjed Abu-Ghname; Michael Bohl; Alexander E. Ropper; Marco Maricevich; Edward M. Reece

doi:10.1055/s-0041-1725986

Seminars in Plastic Surgery, Table of Contents

Semin Plast Surg 2021; 35(01): 037-040
DOI: 10.1055/s-0041-1725986

Review Article

Vascularized Posterior Iliac Crest Bone Grafting: Indications, Techniques, Clinical Outcomes, and Alternatives

Sebastian J. Winocour

¹Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas

,

Kelly P. Schultz

¹Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas

,

Matthew J. Davis

¹Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas

²Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas

,

Amjed Abu-Ghname

¹Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas

²Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas

,

Michael Bohl

³Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona

,

Alexander E. Ropper

⁴Department of Neurosurgery, Baylor College of Medicine, Houston, Texas

,

Marco Maricevich

¹Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas

,

Edward M. Reece

¹Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas

²Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas

⁴Department of Neurosurgery, Baylor College of Medicine, Houston, Texas

› Author Affiliations

Abstract

Pseudarthrosis is a feared complication of spinal fusion procedures. Currently, the gold standard in prevention or treatment of pseudarthrosis is placement of nonvascularized iliac crest bone autograft. While rates of fusion are significantly higher in patients with use of nonvascularized bone autografts than with allografts, patients who have previously failed lumbar arthrodesis or those at a high risk for pseudarthrosis may benefit from a more robust, vascularized bone graft with enhanced osteogenicity. In this article, we discuss the use of iliac crest vascularized bone grafts as an adjunct for high-risk patients undergoing lumbosacral spine arthrodesis.

Keywords

vascularized bone graft - spinoplastic reconstruction - iliac crest - autograft - spinal fusion - pseudoarthrosis

Full Text

References

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