Racial Differences in Iliac Crest Cancellous Bone Composition

Study Design: Retrospective study.Purpose: This study aimed to assess the effect of refilling with hydroxyapatite/collagen (HAp/Col) composite on an iliac crest defect after spinal fusion.Overview of Literature: The use of iliac crest bone graft has been the gold standard in spinal fusion for a long time because of its biological and non-immunologic properties. Few reports have addressed how bone defects recover after iliac crest bone harvest following spinal fusion.Methods: Cancellous bone was collected from the anterior iliac crest during lateral interbody fusion (LIF), and the bone void of the ilium was refilled with a porous HAp/Col composite. We assessed bone recovery using computed tomography (CT). From the 74 patients who underwent LIF between January 2015 and December 2016, we included 49 patients whose iliac crest could be evaluated using CT at 3 months and 1 year after the surgery.Results: Bone defects decreased in a time-dependent manner after the surgery. Cortical closure was observed in 28.5% of the cases 3 months after the surgery; at 1 year postoperatively, 95.9% of the patients had cortical closure. Complete repair of the cancellous bone was achieved in 57.1% of the patients at 3 months after the surgery and in 95.9% at 1 year after the surgery. There were no significant hematomas, infections, iliac crest fractures, or soft tissue herniation.Conclusions: Radiographic recovery of cortical and cancellous bone defects was achieved with high probability via refilling with HAp/Col composite over the 1-year period.

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Optimizing Safety of Iliac Bone Harvest Using an Acumed Drill: A Simulated Radiographic Study of 100 Patients

The Cleft Palate-Craniofacial Journal ◽

10.1597/15-341 ◽

2017 ◽

Vol 54 (6) ◽

pp. 674-679 ◽

Cited By ~ 1

Author(s):

John T. Stranix ◽

Daniel Cuzzone ◽

Catherine Ly ◽

Nicole Topilow ◽

Christopher M. Runyan ◽

...

Keyword(s):

Bone Graft ◽

Cortical Thickness ◽

Cancellous Bone ◽

Reference Point ◽

Iliac Crest ◽

Bowel Perforation ◽

Iliac Bone ◽

Iliac Crest Bone Graft ◽

Visceral Injury ◽

Graft Harvest

Objective To determine the potential risk of visceral injury during Acumed drill iliac crest cancellous bone graft harvest. Design Radiographic iliac crest anatomic analysis with simulated drill course to measure cancellous bone available for harvest and proximity of vulnerable pelvic structures. Setting Single institution, tertiary care university hospital. Patients and Participants One hundred pelvic computed tomography scans performed on children 8 to 12 years old without traumatic or neoplastic pathology. Interventions Radiographic simulation of Acumed drill course within iliac bone. Main Outcome Measures (1) Potential for pelvic visceral injury. (2) Volume of cancellous bone safely available for harvest. Results Superior and medial cortical thickness at the reference point remained stable across age groups; however, lateral cortical thickness increased with age (3.13 to 3.74 mm, P < .001). Cancellous bone width increased with age at all depths measured ( P < .001). Through radiographic simulation, the drill could reach the bowel in 4% of cases and only through gross deviation (>30°) from the plane of the ilium. There were no cases of simulated bowel perforation within 3 cm of the reference point. The maximum cancellous volume safely harvested increased with age: 24 cc in 8-year-olds to 36 cc in 12-year-olds ( P < .001). Conclusions Acumed assisted iliac crest bone graft harvest is a safe technique in which substantial amount of cancellous bone can be obtained. The low risk of bowel perforation can be further minimized by limiting the depth of drill bit penetration to less than 3 cm.

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Cancellous bone in the anterior part of the iliac crest

Calcified Tissue Research ◽

10.1007/bf02012768 ◽

1977 ◽

Vol 23 (1) ◽

pp. 67-76 ◽

Cited By ~ 36

Author(s):

W. J. Whitehouse

Keyword(s):

Cancellous Bone ◽

Iliac Crest ◽

Anterior Part

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Simultaneous Cortex Bone Plate Graft with Particulate Marrow and Cancellous Bone for Reliable Closure of Palatal Fistulae Associated with Cleft Deformities

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_2002_039_0364_scbpgw_2.0.co_2 ◽

2002 ◽

Vol 39 (3) ◽

pp. 364-369 ◽

Cited By ~ 1

Author(s):

Masatoshi Ishii ◽

Yoshimasa Ishii ◽

Takashi Moriyama ◽

Akemi Gunji ◽

Keiichi Morita ◽

...

Keyword(s):

General Anesthesia ◽

Cancellous Bone ◽

Iliac Crest ◽

University Hospital ◽

Bone Plate ◽

Palatal Fistula ◽

Alveolar Cleft ◽

Nasal Floor ◽

Tokyo Medical ◽

Palatal Mucosa

Objective: The purpose of this study was to evaluate the effectiveness of simultaneous cortex bone plate (CBP) graft with particulate marrow and cancellous bone (PMCB) graft for reliable closure of palatal fistulae associated with alveolar clefts. Design: Following standard secondary bone graft preparation of the cleft site, CBP harvested from the medial iliac crest was inserted into the palatal deficiency. This was followed by suturing the palatal mucosa. PMCB was then packed between the cortical bone and the reconstructed nasal floor. Setting: Ten consecutive patients with palatal fistula were operated on at Tokyo Medical and Dental University Hospital from 1998 to 2000. Primary palatal repair was performed in 7 out of 10 patients at our center and in 3 out of 10 patients at other hospitals. Patients: Ten patients (6 boys and men, 4 girls and women) with a palatal fistula associated with an alveolar cleft were studied. Ages ranged from 12 to 26 years. Interventions: All patients underwent simultaneous CBP graft with PMCB graft for closure of palatal fistula under general anesthesia. Results: Complete closure of palatal fistulae were obtained in 8 out of 10 cases. A very small asymptomatic fistula remained in one patient. Total necrosis of the labial flap with a residual palatal fistula occurred in one patient. Conclusions: Simultaneous CBP graft with PMCB graft could be more reliable than PMCB alone for closure of a cleft associated palatal fistula.

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Quantitative Analysis of Cancellous Bone Graft Available from the Greater Trochanter

Foot & Ankle International ◽

10.1177/107110079601700807 ◽

1996 ◽

Vol 17 (8) ◽

pp. 473-476 ◽

Cited By ~ 11

Author(s):

Eric J. Lindberg ◽

Stuart D. Katchis ◽

Ronald W. Smith

Keyword(s):

Bone Graft ◽

Cancellous Bone ◽

Proximal Femur ◽

Iliac Crest ◽

Secondary Source ◽

Cancellous Bone Graft ◽

Greater Trochanter ◽

Graft Harvest ◽

Digital Compression ◽

Trochanteric Region

To quantify the amount of cancellous bone graft available from the greater trochanteric region, 20 paired iliac crest-proximal femur specimens were harvested and compared in 10 adult pelvises. A 1.3 × 1.3-cm cortical window was made in the lateral aspect of the proximal femur 2 cm distal from the tip of the greater trochanter. Cancellous bone evacuation was performed by curettage. The extent of harvest was mechanically limited by the medial wall of the trochanter and by curette impingement on the margins of the cortical window. The graft was quantitated after maximal digital compression in a 10-ml syringe and compared with cancellous graft obtained from the paired anterior iliac crest. The average compressed volume of cancellous bone harvested from the greater trochanter was 6.5 ml (range, 4.2–9.6 ml). The average iliac crest cancellous bone volume was 6.0 ml (range, 2.7–8.8 ml). Differences in graft volume between the anterior iliac crest and the trochanter were not statistically significant. The resulting defect in the proximal femur remained isolated to the trochanteric region. In this study, we demonstrate that cancellous bone is available from the greater trochanteric region in an amount similar to that available from the anterior iliac crest. We also show that it is obtainable in a reproducible manner. Our clinical experience of over 100 cases has demonstrated acceptable morbidity associated with this technique. The greater trochanteric region may be used as a secondary source of autogenous cancellous bone graft when specific procedures demand more bone graft than available from the iliac crest alone, or in patients who have had previous iliac crest graft harvest.

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