A Modified Technique for Harvesting Full-Thickness Iliac Crest Bone Graft

Study Design. A prospective follow-up study of patients undergoing anterior spinal decompression and bone graft with cortical iliac crest bone. Objective. To describe a modified technique for harvesting cortical bone graft from the anterior iliac crest. Summary of Background Data. Cortical bone graft from the iliac crest frequently is used in various orthopedic and spinal procedures. The resulting defect in the iliac crest has been associated with many complications. Methods. Twenty patients were included in this study. All had burst vertebral fracture requiring anterior spinal decompression and cortical bone grafting. The modified technique was used for harvesting the iliac crest bone graft in all patients. Results. All patients were satisfied with the appearance of the iliac crest. None reported chronic pain at the graft site. None had fracture of the iliac wing, and none had symptoms related to the lateral femoral cutaneous nerve or herniation of pelvic contents through the bony defect in the iliac wing. Conclusion. This modified technique is technically straightforward and cost-effective. It preserves the contour and shape of the iliac crest and avoids cosmetic deformities and chronic pain at the graft site. It creates a window in the iliac wing rather than disrupting the continuity of the iliac crest, which leaves the iliac wing structurally stronger than with currently used techniques.