Banwart J C, Asher M A, Hassanein R S
Section of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, USA.
Spine (Phila Pa 1976). 1995 May 1;20(9):1055-60. doi: 10.1097/00007632-199505000-00012.
This study analyzed the cause, rate, and risk factors of iliac crest bone graft donor site morbidity.
All complications or problems, no matter how small, were sought to develop strategies of prevention.
A wide range of major, 0.76% (Keller et al) to 25% (Summers et al) and minor complications, 9.4% (Keller et al) to 24% (Summers et al) has been reported.
A consecutive series of 261 patients, whose bone graft harvest was done by one surgeon, was studied by chart review and a mail survey that was not conducted by the operating surgeon. The survey presented specific open-ended questions designed to uncover any complication/problem, no matter how small. Complications then were categorized as major or minor and subcategorized as acute or chronic. Statistical analysis was done using chi-squared and multiple logistical regression.
None of the 261 patients had a severe perioperative complication--e.g., superior gluteal artery injury, sciatic nerve injury, or deep wound infection. None of the 225 patients with long term follow-up (average, 66 months; range, 32-105 months) had a severe late complication--e.g., donor site herniation, meralgia paresthetica, pelvic instability, or fracture. Of the 180 patients meeting the qualifications for statistical analysis, major complications occurred in 18 (10%), only three of which affected function (pain). Minor complications occurred in 70 (39%).
The results indicated that severe complications from iliac crest bone graft harvest can be avoided and major complications affecting functioning are uncommon, but minor complications are common. The findings suggest that procedural refinements of limiting subcutaneous dissection and providing layered tension-free incision closure may improve results.
本研究分析了髂嵴骨移植供区发病的原因、发生率及危险因素。
探寻所有并发症或问题，无论多么轻微，以制定预防策略。
已报道了广泛的严重并发症，发生率从0.76%（凯勒等人）至25%（萨默斯等人），以及轻微并发症，发生率从9.4%（凯勒等人）至24%（萨默斯等人）。
通过病历回顾和由非手术医生进行的邮件调查，对连续261例由同一外科医生进行髂嵴骨采集的患者进行研究。该调查提出了特定的开放式问题，旨在发现任何并发症/问题，无论多么轻微。并发症随后被分为严重或轻微，并进一步细分为急性或慢性。使用卡方检验和多元逻辑回归进行统计分析。
261例患者中无一例发生严重围手术期并发症，如臀上动脉损伤、坐骨神经损伤或深部伤口感染。在225例接受长期随访的患者中（平均66个月；范围32 - 105个月），无一例发生严重晚期并发症，如供区疝、感觉异常性股痛、骨盆不稳定或骨折。在符合统计分析条件的180例患者中，18例（10%）发生了严重并发症，其中只有3例影响功能（疼痛）。70例（39%）发生了轻微并发症。
结果表明，髂嵴骨采集的严重并发症可以避免，影响功能的严重并发症并不常见，但轻微并发症很常见。研究结果表明，限制皮下剥离和提供分层无张力切口闭合的手术改进可能会改善结果。
