Complaints and findings at the iliac crest donor site following anterior cervical fusion

Abstract

A high rate of donor site complications has been described following bone graft harvesting at the anterior iliac crest for anterior cervical fusion. However, no prospective study exists dealing with this topic. The objectives of the study presented were to evaluate minor and major donor site complications following graft harvesting at the anterior iliac crest, to investigate postoperative changes at the donor site using computed tomography and ultrasound imaging and to judge the patients satisfaction. 67 patients were included in a clinical prospective study. All patients underwent anterior cervical discectomy and fusion using an autologous iliac crest graft. Clinical examination was performed three and ten days and two and three months after the operation. Computed tomography and ultrasound imaging of the donor site were performed 10 days after surgery. Complications were classified as "minor" and "major" complications. Minor complications were found in 62.7%. A significant decrease of minor complication rate was seen between the first and second examination after surgery. At the last follow-up, 80.5% of all patients were free from pain concerning the donor site. Haematomas and seromas were detected by ultrasound in 67.2% and donor site fractures in 6% using computed tomography. Major complications were seen in 11.9% of all patients. The current study revealed a high rate of minor complications and haematomas at the graft donor site. However, the majority of all patients is free of pain at the donor site three months after surgery and satisfied with the surgical result. Techniques without the need of bone grafting may help to avoid these complications and to ameliorate the initial postoperative status.