S Le Pape1, L Du Pouget2, T Cloche3, M Campana3, I Obeid3, L Boissiere3, J-M Vital3. 1. Regional Spine Institute, University Hospital of Rouen, Rue de Germont, 76000, Rouen, France. sebastien.lepape@gmail.com. 2. Urology Department, University Hospital of Rouen, Rouen, France. 3. Spine Unit 1, University Hospital Pellegrin, Bordeaux, France.
Abstract
PURPOSE: For the past few years, anterior exposure for surgery of the lumbar spine has gained popularity for the treatment of disk disease or spondylosis. Cancellous bone remains the gold standard for fusion. Iliac crest bone harvesting is safe but there are donor site complications. Bone substitutes exist, like recombinant human bone morphogenic protein-2 rhBMP-2. This alternative offers a high rate of fusion but with local and general complications. The aim of our study is to show the feasibility of an endopelvic approach for iliac bone crest harvesting to avoid donor site complication. METHOD: Twenty anterior retroperitoneal lumbar spine approaches have been realized in the anatomy department of the University of Bordeaux. The volumes of cancellous bone have been measured and procedure complications have been reported. RESULTS: The mean volume of cancellous bone was 5.9 cc, the maximum volume was 8.2 cc and the minimum volume was 4.5 cc. No complications have been reported during the approach or the bone harvesting. CONCLUSIONS: Anterior retroperitoneal approach for iliac bone crest harvesting is a safe way to obtain sufficient volume of cancellous bone for a single lumbar spinal fusion. This exposure avoids the risks of an iliac crest donor site complications or rhBMP-2 complications.
PURPOSE: For the past few years, anterior exposure for surgery of the lumbar spine has gained popularity for the treatment of disk disease or spondylosis. Cancellous bone remains the gold standard for fusion. Iliac crest bone harvesting is safe but there are donor site complications. Bone substitutes exist, like recombinant human bone morphogenic protein-2 rhBMP-2. This alternative offers a high rate of fusion but with local and general complications. The aim of our study is to show the feasibility of an endopelvic approach for iliac bone crest harvesting to avoid donor site complication. METHOD: Twenty anterior retroperitoneal lumbar spine approaches have been realized in the anatomy department of the University of Bordeaux. The volumes of cancellous bone have been measured and procedure complications have been reported. RESULTS: The mean volume of cancellous bone was 5.9 cc, the maximum volume was 8.2 cc and the minimum volume was 4.5 cc. No complications have been reported during the approach or the bone harvesting. CONCLUSIONS: Anterior retroperitoneal approach for iliac bone crest harvesting is a safe way to obtain sufficient volume of cancellous bone for a single lumbar spinal fusion. This exposure avoids the risks of an iliac crest donor site complications or rhBMP-2 complications.
Entities:
Keywords:
Bone graft; Endopelvic approach; Iliac crest; Interbody fusion; Lumbar spine surgery
Authors: Alexander R Vaccaro; Kazuhiro Chiba; John G Heller; Tushar Ch Patel; John S Thalgott; Eeric Truumees; Jeffrey S Fischgrund; Matthew R Craig; Scott C Berta; Jeffrey C Wang Journal: Spine J Date: 2002 May-Jun Impact factor: 4.166
Authors: Kwang-Bok Lee; Cyrus E Taghavi; Margaret S Hsu; Kyung-Jin Song; Jeong Hyun Yoo; Gun Keorochana; Stephanie S Ngo; Jeffrey C Wang Journal: Eur Spine J Date: 2009-12-30 Impact factor: 3.134
Authors: Rozalia Dimitriou; George I Mataliotakis; Antonios G Angoules; Nikolaos K Kanakaris; Peter V Giannoudis Journal: Injury Date: 2011-06-25 Impact factor: 2.586
Authors: David H Kim; Richard Rhim; Ling Li; Juli Martha; Bryan H Swaim; Robert J Banco; Louis G Jenis; Scott G Tromanhauser Journal: Spine J Date: 2009-06-18 Impact factor: 4.166