Iliac crest reconstruction after tricortical graft harvesting

Twenty-eight patients underwent anterior iliac crest reconstruction after the harvesting of autogenous tricortical graft. The anterior iliac crest was reconstructed using the resected rib from the thoracoabdominal approach. The authors evaluated graft site pain and residual deformity, radiographic evidence of rib incorporation, and the incidence of lateral femoral cutaneous nerve injury. There were no reports of graft site pain greater than "acceptable" levels, requiring nonnarcotic analgesics on an intermittent basis and not interfering with activities of daily living. Four lateral femoral cutaneous nerve neuropraxias were recorded, none of clinical significance. The authors advocate the use of autogenous tricortical anterior iliac crest bone graft when performing reconstructive spinal surgery, followed by reconstruction of the iliac crest with the resected rib from the surgical approach.