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

AbstractPseudarthrosis 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.

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Open aortic arch replacement in high-risk patients: the gold standard

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezv149 ◽

2015 ◽

Vol 49 (2) ◽

pp. 646-651 ◽

Cited By ~ 11

Author(s):

Mauro Iafrancesco ◽

Aaron M. Ranasinghe ◽

Vamsidhar Dronavalli ◽

Donald J. Adam ◽

Martin W Claridge ◽

...

Keyword(s):

High Risk ◽

Aortic Arch ◽

Gold Standard ◽

Aortic Arch Replacement ◽

High Risk Patients ◽

Risk Patients

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Diagnostic Accuracy of Stop-Bang Questionnaire in Diagnosing High Risk Patients of Obstructive Sleep Apnea Considering Polysomnography as a Gold Standard

10.53350/pjmhs2115102823 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2823-2825

Author(s):

Masood uz Zaman Babar ◽

Rizwan Ali Tunio ◽

Sunil Dat Maheshwari ◽

Ali Hassan ◽

Hasham Masood Qureshi

Keyword(s):

Obstructive Sleep Apnea ◽

Standard Deviation ◽

Sleep Apnea ◽

High Risk ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Gold Standard ◽

High Risk Patients ◽

Obstructive Sleep ◽

Risk Patients

Objective: To determine the diagnostic accuracy of stop-bang questionnaire to diagnose high risk patients of obstructive sleep apnea taking polysomnography as gold standard. Methodology: This cross-sectional descriptive study was conducted at Isra University Hospital Hyderabad and help taken from Sleep Disorder Laboratory, The Aga Khan Hospital, Karachi. Patients with age of 18 to 70 years, presenting with symptoms of OSA of either gender were included. History was taken from patients. STOP- BANG Questionnaire was filled out for each patient consenting to participate in the study. All information was noted and entered in the Proforma. Results: Mean age of patients was 40.1 with standard deviation 17.6, mean AHI score was 20 with standard deviation 6 and stop bang score showed average 6.8 with standard deviation 2.7. Distribution of gender showed that most of the patients were male. Diagnostic accuracy calculated for stop bang questionnaire, sensitivity 77.2%, Specificity 65.5%, Positive Predictive Value 75.4%, Negative Predictive Value 67.8%, Diagnostic Accuracy 72.3% of stop bang questionnaire as follows. Conclusion: This study confirms the STOP-Bang questionnaire's high performance in screening for Obstructive sleep apnea (OSA) in the surgical population and sleep clinic. The likelihood of OSA severity increases from moderate to severe with the increasing STOP-Bang score. Keywords: Obstructive sleep apnea, stop-bang questionnaire, apnea-hypopnea index, polysomnogram

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044 * OPEN AORTIC ARCH REPLACEMENT IN HIGH RISK PATIENTS: THE GOLD STANDARD

Interactive Cardiovascular and Thoracic Surgery ◽

10.1093/icvts/ivu276.44 ◽

2014 ◽

Vol 19 (suppl 1) ◽

pp. S14-S14

Author(s):

M. Iafrancesco ◽

A. Ranasinghe ◽

V. Dronavalli ◽

D. Adam ◽

M. Claridge ◽

...

Keyword(s):

High Risk ◽

Aortic Arch ◽

Gold Standard ◽

Aortic Arch Replacement ◽

High Risk Patients ◽

Risk Patients

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Complications of Posterior Iliac Crest Bone Grafting in Spine Surgery in Children

Spine ◽

10.1097/00007632-200009150-00021 ◽

2000 ◽

Vol 25 (18) ◽

pp. 2400-2402 ◽

Cited By ~ 110

Author(s):

David L. Skaggs ◽

Michael A. Samuelson ◽

Julie M. Hale ◽

Robert M. Kay ◽

Vernon T. Tolo

Keyword(s):

Spine Surgery ◽

Bone Grafting ◽

Iliac Crest ◽

Posterior Iliac Crest ◽

Iliac Crest Bone Grafting

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Treatment of Navicular Stress Fractures With an Algorithmic Approach

Foot & Ankle International ◽

10.1177/10711007211034812 ◽

2021 ◽

pp. 107110072110348

Author(s):

James A. Nunley ◽

Cynthia Green ◽

Joel Morash ◽

Mark E. Easley

Keyword(s):

Internal Fixation ◽

Bone Grafting ◽

Open Reduction ◽

Iliac Crest ◽

Stress Fractures ◽

Ct Scans ◽

Return To Sports ◽

Iliac Crest Bone Grafting ◽

Difficult Cases ◽

Vascularized Bone

Background: Navicular stress fractures are becoming increasingly more common. There is no universal consensus on treatment. We provide an algorithm that we feel will be useful in determining treatment. Methods: A retrospective study was performed on all patients having operative treatment of navicular stress fractures during a 10-year period. Acute fractures were treated with open reduction internal fixation. Chronic fractures greater than 3 months were treated with open reduction and internal fixation (ORIF) and iliac crest bone grafting. Chronic fractures with evidence of sclerosis, avascular changes, or those who failed previous surgery were treated with ORIF, iliac crest bone grafting, as well as vascular bone grafting. Patients’ pain scores were recorded and a return-to-sports scale was used. Radiographic union was compared among the 3 groups using computed tomographic (CT) scans or radiographs. Results: Forty-three patients were identified. Fifteen received ORIF alone, 12 were treated with ORIF and bone graft, and 16 had ORIF with vascularized bone grafting. No difference was found among the median age of the 3 groups. In terms of radiographic healing, 3 patients in the ORIF group received radiographs alone. All other patients had follow-up CT scans. ORIF alone group had 80% union, ORIF with bone graft had 75% union, and ORIF with vascularized bone grafting had 100% union. Return to sports did not show any difference among the 3 groups. Conclusion: The algorithm dividing navicular stress fractures into 3 distinct groups with different operative techniques helped us address these difficult cases. Vascularized bone grafting certainly appeared to be beneficial for the more difficult cases. Level of Evidence: Level IV, case series.

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