Iliac Crest Bone Graft Harvest and Fusion Techniques


Approximately 250,000 bone grafting procedures are performed annually in the United States for spinal surgery. Anterior and posterior autologous iliac crest bone grafts (A/PICG) are commonly used in spinal surgery for spinal reconstruction and to obtain fusion. The clinical outcome of autologous iliac crest bone graft usage is more predictable compared to other grafting materials, including allograft, xenograft, and synthetic materials. The basic principles of an anterior cervical discectomy (ACD) or corpectomy (ACC) and fusion procedure includes decompression followed by restoration of the anterior column with a structural graft to achieve a biologic bony union. A structural cortical autologous bone graft has intrinsic stability and provides support while autologous cancellous bone provides cells and protein important for fusion success and a substrate for osteoconduction. However, it contributes no biologic support or structural stability. Autologous cancellous bone is frequently harvested from either the anterior or posterior iliac crest and is placed either anteriorly in a structural cage or posteriorly along the posterolateral cerical masses or intertransverse processes.


Bone Graft Iliac Crest Autologous Bone Graft Anterior Lumbar Interbody Fusion Lateral Femoral Cutaneous Nerve 


  1. 1.
    Cauthen JC, Kinard RE, Vogler JB, et al. Outcome analysis of noninstrumented anterior discectomy and interbody fusion in 348 patients. Spine. 1998;23:188–192.CrossRefPubMedGoogle Scholar
  2. 2.
    Cloward RB. The anterior approach for ruptured cervical discs. J Neurosurg. 1958;15:502–514.Google Scholar
  3. 3.
    Connolly PJ, Essess SI, Kostuik JP. Anterior cervical fusion: outcome analysis of patients fused with and without anterior cervical plates. J Spinal Disord. 1996;9:202–206.PubMedGoogle Scholar
  4. 4.
    Robinson RA, Walker AE, Ferlick DC, et al. The results of anterior interbody fusion of the cervical spine. J Bone Joint Surg (Am). 1962;44:1569–1587.Google Scholar
  5. 5.
    Wang JC, McDough PW, Endow K, et al. The effect of cervical plating on one-level anterior cervical discectomy and fusion. J Spinal Disord. 1999;12:467–471.CrossRefPubMedGoogle Scholar
  6. 6.
    Zoega B, Karrholm J, Lind B. One-level cervical fusion. A randomized study with or without plate fixation, using radiostereometry in 27 patients. Acta Orthop Scand. 1998;69:363–368.PubMedCrossRefGoogle Scholar
  7. 7.
    Wang JC, McDough PW, Endow K, et al. Increased fusion rates with cervical plating for two-level anterior cervical discectomy and fusion. Spine. 2000;25:41–45.CrossRefPubMedGoogle Scholar
  8. 8.
    Arrington ED, Smith WJ, Chambers HG, Bucknell AL, Davino NA. Complications of iliac crest bone graft harvesting. Clin Orthop. 1996;329:300–309.CrossRefPubMedGoogle Scholar
  9. 9.
    Banwart JC, Asher MA, Hassanein RS. Iliac crest bone graft harvest donor site morbidity: a statistical evaluation. Spine. 1995;20:1055–1060.CrossRefPubMedGoogle Scholar
  10. 10.
    Cockin, J. Autologous bone-grafting complications at the donor site. J Bone Joint Surg (Br). 1971;49:153.Google Scholar
  11. 11.
    Si lber JS, Anderson DG, Daffner S, et al. Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion. Spine. 2003;28:134–139.CrossRefPubMedGoogle Scholar
  12. 12.
    Robertson PA, Wray AC. Natural history of posterior iliac crest bone graft donation for spinal surgery: a prospective analysis of morbidity. Spine. 2001;26:1473–1476.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryLong Island Jewish Medical CenterNew Hyde ParkUSA
  2. 2.Albert Einstein School of MedicineBronxUSA

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