Global spine journal
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Global spine journal · Jun 2015
ReviewIliac Crest Bone Graft in Lumbar Fusion: The Effectiveness and Safety Compared with Local Bone Graft, and Graft Site Morbidity Comparing a Single-Incision Midline Approach with a Two-Incision Traditional Approach.
Study Design Systematic review. Clinical Questions (1) Is autologous local bone (LB) graft as safe and effective as iliac crest bone graft (ICBG) in lumbar spine fusion? (2) In lumbar fusion using ICBG, does a single-incision midline approach reduce postoperative iliac crest pain compared with a two-incision traditional approach? Methods Electronic databases and reference lists of key articles were searched up to October 2014 to identify studies reporting the comparative efficacy and safety of ICBG versus LB graft or comparing ICBG harvest site for use in lumbar spine surgery. Studies including allograft, synthetic bone, or growth factors in addition to ICBG and those with less than 80% of patients with degenerative disease in the lumbar spine were excluded. ⋯ Only 19% of the patients with ICBG harvested through the single-incision midline approach on either the right or the left side of the ilium reported pain that was concordant with the side that was actually harvested. Conclusions LB is as safe and efficacious as ICBG for instrumented fusion in the lumbar spine to treat degenerative disease. When ICBG is used, graft harvest through the single-incision midline approach reduces postoperative iliac crest pain compared with a two-incision approach.