The Incidence of Donor Site Pain After Bone Graft Harvesting From the Posterior Iliac Crest May Be Overestimated

Abstract

Patients probably cannot differentiate between donor site pain and residual low back pain. The reported incidence of pain related to posterior iliac crest bone graft harvesting may therefore be overestimated.

Mid- to long-term outcome of instrumented anterior cervical fusion for subaxial injuries

“…In contrast, Shamsaldin et al [84] demonstrated that after harvesting bone from the iliac crest for 1-level ACDF, 92% had no persisting pain after 1 year. Likewise, in a series on thoracolumbar fractures Delawi et al [22] reported donor site pain in 14%, but 'pain' on a VAS averaged 1.6 only [22]. Our findings concur with that of Delawi and Shamsaldin with the patients' iliac crest related pain averaging only 0.5 on a VAS.…”

Can Porous Tantalum Be Used to Achieve Ankle and Subtalar Arthrodesis?: A Pilot Study

“…Tantalum has the advantage that it avoids donor-site morbidity of harvesting the iliac crest graft and the possibility of disease transmission. Harvesting autograft at the iliac crest has a reported donorsite morbidity rate of 15% to 48% (postoperative hematoma, infection, hypesthesia, increased postoperative pain, wound dehiscence, cosmetic defect, prolonged pain in the long term, and impairment in ambulation, work, and activities of daily living [17,21,24,38,42]). The cost of tantalum (approximately $1000 per block in the US) is comparable to allograft ($850, plus approximately [3,4,56] Similar to gold standard [19,54] Difficult radiographic assessment of fusion [28,51,54] No donor-site morbidity, no reported complications [19,20,36,37,54] Unlimited Approximately $1000 per piece 5 minutes of preparation time in the operating theater) or harvesting iliac crest autograft (estimated at $600 to $700, as it involves approximately 20 minutes of operating time, suture material, sponges, and dressing) ( Table 1).…”

“…Recognized options currently include autograft, allograft, and xenograft bone, each associated with certain disadvantages. Autograft, which is considered the gold standard for bone grafting because of its high healing potential, is associated with donor-site morbidity in 15% to 48% [17,21,24,38,42,45], postoperative complications (hematoma, hypoesthesia, wound dehiscence) in 3% to 39% [24,38,42], limited quantity, and risk of graft collapse [24]. Allograft and xenograft carry the risk of infectious disease transmission, lower stability attributable to the preparation process, and potential failure to integrate, which can result in graft collapse and failure of surgery [6,24,35].…”

Iliac crest reconstruction to reduce donor-site morbidity: technical note

“…Some studies have shown that the incidence of donor-site pain is significantly increased in lumbar or lumbrosacral spinal surgery compared with cervical or thoracic surgery [7,8,15,17]. One group has suggested that this is due to the inability of the patient to differentiate donor-site from primary surgery site pain [15]. Other authors have suggested this phenomenon is due to biomechanical implications of destabilizing the pelvis in patients receiving lumbrosacral fusions [7,8].…”

“…Numerous, uncontrolled, retrospective studies have reported their incidence of persistent donor-site pain and it has now been widely accepted to be common, occurring in one-third of patients undergoing autogenous harvest from the iliac crest [5,6,8,10,11,[13][14][15][16][17][18][19]. Some studies have shown that the incidence of donor-site pain is significantly increased in lumbar or lumbrosacral spinal surgery compared with cervical or thoracic surgery [7,8,15,17]. One group has suggested that this is due to the inability of the patient to differentiate donor-site from primary surgery site pain [15].…”