Semin Plast Surg 2021; 35(01): 037-040
DOI: 10.1055/s-0041-1725986
Review Article

Vascularized Posterior Iliac Crest Bone Grafting: Indications, Techniques, Clinical Outcomes, and Alternatives

Sebastian J. Winocour
1   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
,
Kelly P. Schultz
1   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
,
Matthew J. Davis
1   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
2   Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas
,
Amjed Abu-Ghname
1   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
2   Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas
,
Michael Bohl
3   Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona
,
Alexander E. Ropper
4   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
,
Marco Maricevich
1   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
,
Edward M. Reece
1   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
2   Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas
4   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
› Author Affiliations

Abstract

Pseudarthrosis is a feared complication of spinal fusion procedures. Currently, the gold standard in prevention or treatment of pseudarthrosis is placement of nonvascularized iliac crest bone autograft. While rates of fusion are significantly higher in patients with use of nonvascularized bone autografts than with allografts, patients who have previously failed lumbar arthrodesis or those at a high risk for pseudarthrosis may benefit from a more robust, vascularized bone graft with enhanced osteogenicity. In this article, we discuss the use of iliac crest vascularized bone grafts as an adjunct for high-risk patients undergoing lumbosacral spine arthrodesis.



Publication History

Article published online:
10 May 2021

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