Trephine Technique for Iliac Crest Bone Graft Harvest: Long-term Results
| Autor: | Robert F. McLain, Fernando Techy |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Visual analogue scale medicine.medical_treatment Anterior cervical discectomy and fusion Iliac crest Transplantation Autologous Ilium 03 medical and health sciences Fractures Bone 0302 clinical medicine Postoperative Complications Surveys and Questionnaires medicine Humans Orthopedics and Sports Medicine Aged Pain Measurement 030222 orthopedics Pain Postoperative Bone Transplantation business.industry Wound dehiscence Perioperative Middle Aged medicine.disease Spine Surgery Transplantation medicine.anatomical_structure Spinal Fusion Treatment Outcome Trephine Patient Satisfaction Spinal fusion Spinal Diseases Neurology (clinical) Morbidity business 030217 neurology & neurosurgery Diskectomy |
| Zdroj: | Spine. 46(1) |
| ISSN: | 1528-1159 |
| Popis: | Study design Report of surgical technique and long-term outcome; review of prospectively gathered data and follow-up survey of patient cohort. Objective The aim of this study was to review surgical technique for a trephine graft harvest technique and assess perioperative complications/pain, long-term outcome, and patient satisfaction after anterior iliac crest bone graft (ICBG) harvest for anterior cervical fusion. Summary of background data Rates of complications and residual pain after ICBG harvest have reduced its utility as a source of autograft for spinal fusion. Less invasive options reduce morbidity, and trephine harvest is a simple technique, with low morbidity and perioperative and long-term pain. It has not been presented in the peer-reviewed spine literature, and the long-term experience has not been previously reported. Methods Sixty-eight patients undergoing anterior cervical discectomy and fusion (ACDF), using allograft spacers, underwent ICBG harvest using a 3.5 mm trephine by a minimally invasive approach. Perioperative complications, pain incidence and Visual Analog Scale (VAS) were analyzed. Thirty consecutive patients were subsequently surveyed for long-term follow-up regarding pain, function, and satisfaction. Results No perioperative (0-6 weeks) graft-site complications (infection, hematoma, fracture, wound dehiscence) occurred. There were no reoperations, and no treatment required for graft-site complaints. No patient reported clinically significant perioperative pain (>3/10). At long-term follow-up (mean 45 months) no patients reported pain >3/10 at their graft-site, and the mean VAS was 0.20/10. No patient was impaired by graft-site symptoms, and all were satisfied with their graft harvest. Conclusion Trephine graft harvest minimizes soft tissue dissection, periosteal elevation, and cortical disruption. Outcome using this technique eliminated perioperative complications in this study group, and reduced pain in both perioperative and long-term assessments. Compared to historical outcomes, trephine harvest provides sufficient graft with comparable or improved results relative to other minimally invasive approaches, and significantly improved relative to traditional open techniques. Level of evidence 4. |
| Databáze: | OpenAIRE |
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