Chi Heon Kim1, Chun Kee Chung2, Yunhee Choi3, Sun Tae Hwang4, Sung-Mi Kim5, Sung Bae Park6. 1. Department of Neurosurgery, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea; Department of Neurosurgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea; Clinical Research Institute, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea. 2. Department of Neurosurgery, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea; Department of Neurosurgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea; Clinical Research Institute, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea. Electronic address: chungc@snu.ac.kr. 3. Medical Research Collaborating Center, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea. 4. Department of Integrative Plant Science, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Republic of Korea. 5. Department of Neurosurgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea. 6. Department of Neurosurgery, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea; Clinical Research Institute, Seoul National University Hospital, 101, Daehak-ro, Jongno-Gu, Seoul 03080, Republic of Korea; Department of Neurosurgery, Seoul National University Boramae Hospital, Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Republic of Korea.
Abstract
BACKGROUND: Anterior cervical fusion (ACF) with autologous iliac bone graft is a traditional surgical method, but high rate of chronic pain (30%) at the anterior iliac crest presents a considerable hindrance to harvesting iliac bone. The memory of acute pain may become fainter as time progresses, and the incidence of chronic pain may not be as high as previously reported. The primary objective was to show the patient-reported outcome of chronic pain in the anterior iliac crest. METHODS: Telephone surveys were conducted for patients with single-level ACF (group-S; n=72; M:F=52:20; median age, 53years), multiple-level ACF (group-M; n=61; M:F=40:21; 56years) using autologous iliac bone, and single-level ACF with a stand-alone cage (group-C; n=53; M:F=38:15; 51years). Logistic regression analysis was performed to determine the risk factors, and the variables included group, age, gender, postoperative period and satisfaction with the surgical outcome. RESULTS: There was no chronic pain in 87% of the patients, with no difference among the groups (p=0.52). During the acute postoperative period, patients remembered no pain in 38/72 (53%) patients of group-S, 25/61 (41%) of group-M and 42/53 (79%) of group-C (p<0.001). Female gender (p=0.027; OR, 2.68; 95% CI, 1.12-6.41) was the risk factor for chronic pain. CONCLUSIONS: Iliac bone harvest may not cause chronic pain in 87% of patients, and the memory of acute pain was faded in 40-50% of patients. Female gender was a risk factor for chronic pain. This information should be considered before harvesting iliac bone.
BACKGROUND: Anterior cervical fusion (ACF) with autologous iliac bone graft is a traditional surgical method, but high rate of chronic pain (30%) at the anterior iliac crest presents a considerable hindrance to harvesting iliac bone. The memory of acute pain may become fainter as time progresses, and the incidence of chronic pain may not be as high as previously reported. The primary objective was to show the patient-reported outcome of chronic pain in the anterior iliac crest. METHODS: Telephone surveys were conducted for patients with single-level ACF (group-S; n=72; M:F=52:20; median age, 53years), multiple-level ACF (group-M; n=61; M:F=40:21; 56years) using autologous iliac bone, and single-level ACF with a stand-alone cage (group-C; n=53; M:F=38:15; 51years). Logistic regression analysis was performed to determine the risk factors, and the variables included group, age, gender, postoperative period and satisfaction with the surgical outcome. RESULTS: There was no chronic pain in 87% of the patients, with no difference among the groups (p=0.52). During the acute postoperative period, patients remembered no pain in 38/72 (53%) patients of group-S, 25/61 (41%) of group-M and 42/53 (79%) of group-C (p<0.001). Female gender (p=0.027; OR, 2.68; 95% CI, 1.12-6.41) was the risk factor for chronic pain. CONCLUSIONS: Iliac bone harvest may not cause chronic pain in 87% of patients, and the memory of acute pain was faded in 40-50% of patients. Female gender was a risk factor for chronic pain. This information should be considered before harvesting iliac bone.
Authors: Shin Won Kwon; Chi Heon Kim; Chun Kee Chung; Tae Hyun Park; Su Heon Woo; Sung-Jae Lee; Seung Heon Yang Journal: J Korean Neurosurg Soc Date: 2017-10-25