Morbidity after iliac crest bone graft harvesting over an anterior versus posterior approach
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Purpose: For larger augmentations before implant insertions, as well as spinal arthrodesis surgery, the iliac crest is the standard source of bone grafting. This study assesses iliac morbidity after bone graft harvesting from the anterior and posterior ilium.
Materials and Methods: A total of 97 patients who underwent corticocancellous iliac crest bone harvesting for augmentations of the jaws from 2004 to 2007 at the Department of Oral and Maxillofacial Surgery, University Hospital Kiel, Kiel, Germany, were included. Their morbidity was assessed with specially designed questionnaires.
Results: Pain levels were rated nearly equally on a visual analog scale (1, no pain; 10, strongest pain) by the anterior and posterior groups. At 1 week after bone harvesting, pain was rated 4.9 for the anterior approach and 4.8 for posterior (P _ .89). The corresponding values after 6 months were 1.4 and 1.6, respectively (P _ .64). Subjective evaluation of the scars showed scores of 2.7 and 3.0, respectively (P _ .76). Of the patients, 81% and 88%, respectively, would opt to undergo the operation again.
Conclusions: Patients reported a noticeable reduction in quality of life after elective bone graft harvesting. Nevertheless, nearly all patients would undergo the same procedure again. Both approaches were rated similarly, so for smaller amounts of bone graft needed, the anterior and posterior approaches can be recommended, whereas the posterior approach is suitable for larger amounts.
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