Iliac crest versus spinous process grafts in posttraumatic spinal fusions

Area of Science:

• Orthopedic Surgery
• Spine Surgery
• Bone Grafting

Background:

• Autogenous iliac crest grafts are commonly used for spinal fusion but are associated with donor site morbidity.
• Evaluating alternative bone graft sources is crucial for improving surgical outcomes in spine fusion procedures.

Purpose of the Study:

• To compare the efficacy and safety of autogenous spinous process grafts versus iliac crest grafts in posttraumatic spine fusions.

Main Methods:

• Retrospective comparison of 34 patients receiving iliac crest grafts and 70 patients receiving spinous process grafts for posttraumatic spine fusion.
• Analysis of fusion rates, operative time, blood loss, and donor site complications.

Main Results:

• Spinous process grafts achieved a 100% fusion rate compared to 94% for iliac crest grafts.
• Iliac crest grafts were associated with significantly longer operative times (225 vs. 200 minutes) and greater blood loss (1371 vs. 1136 cc).
• Five patients (15%) in the iliac crest group experienced significant donor site complications, while none occurred in the spinous process group.

Conclusions:

• Autogenous spinous process grafts provide an effective alternative to iliac crest grafts for posttraumatic spine fusion.
• Spinous process grafts reduce surgical burden and donor site morbidity without compromising fusion rates.