04230nas a2200493   4500008004100000022004700041245012200088210006900210250001000279260001100289300001200300490000700312520264800319653003402967653003703001653003103038653001803069653005403087653003303141653002003174653001103194653002203205653001103227653002903238653000903267653006803276653003503344653004403379653001903423653001603442653002603458653004003484653000903524653001803533100001603551700001803567700001703585700001703602700001603619700001903635700001703654700001603671856004903687       2003                        eng d  a1528-1159 (Electronic) 0362-2436 (Linking)00aDonor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion0 aDonor site morbidity after anterior iliac crest bone harvest for  a37646  cJan 15  a134 - 90 v283 aSTUDY DESIGN: This retrospective, questionnaire-based investigation evaluated iliac crest bone graft (ICBG) site morbidity in patients having undergone a single-level anterior cervical discectomy and fusion (ACDF) procedure performed by a single surgeon (T.J.A.). OBJECTIVE: To evaluate acute and chronic problems associated with anterior ICBG donation, particularly long-term functional outcomes and impairments caused by graft donation. SUMMARY OF BACKGROUND DATA: Anterior cervical discectomy and fusion procedures frequently use autologous anterior ICBG to facilitate osseous union. Although autologous ICBG offers several advantages over alternative grafting materials, donor site morbidity can be significant. Acute and chronic complications of donor sites have been reported, yet there are currently no reports of long-term functional outcomes after autologous anterior ICBG donation after single-level ACDF. METHODS: A questionnaire was mailed to 187 consecutive patients who were retrospectively identified to have undergone autologous anterior ICBG harvest for single-level ACDF between 1994 and 1998. The questionnaire divided items into symptomatic (acute and chronic) and functional assessments. Patients answered yes, no, or not applicable; pain was assessed with a Visual Analogue Scale (VAS). RESULTS: Surveys were completed either by mail or follow-up telephone interview by 134 patients (71.6%). Average follow-up was 48 months (range, 24-72 months). Acute symptoms were reported at the following rates: ambulation difficulty, 50.7%; extended antibiotic usage, 7.5%; persistent drainage, 3.7%; wound dehiscence, 2.2%; and incision and drainage, 1.5%. The chronic symptom questionnaire demonstrated a high degree of satisfaction with the cosmetic result (92.5%). Pain at the donor site was reported by 26.1% of patients with a mean VAS score of 3.8 in 10, and 11.2% chronically use pain medication. Twenty-one patients (15.7%) reported abnormal sensations at the donor site, but only 5.2% reported discomfort with clothing. A unique functional assessment revealed current impairments at the following rates: ambulation, 12.7%; recreational activities, 11.9%; work activities, 9.7%; activities of daily living, 8.2%; sexual activity, 7.5%; and household chores, 6.7%. CONCLUSIONS: A large percentage of patients report chronic donor site pain after anterior ICBG donation, even when only a single-level ACDF procedure is performed. Moreover, long-term functional impairment can also be significant. Patients should be counseled regarding these potential problems, and alternative sources of graft material should be considered.10a*Diskectomy / adverse effects10a*Spinal Fusion / adverse effects10aActivities of Daily Living10aAcute Disease10aBone Transplantation / *adverse effects / methods10aCervical Vertebrae / surgery10aChronic Disease10aFemale10aFollow-Up Studies10aHumans10aIlium / *transplantation10aMale10aOutcome Assessment (Health Care) / *statistics & numerical data10aPain, Postoperative / etiology10aPostoperative Complications / *etiology10aQuestionnaires10aReoperation10aRetrospective Studies10aSurgical Wound Infection / etiology10aTime10aUnited States1 aSilber, J S1 aAnderson, D G1 aDaffner, S D1 aBrislin, B T1 aLeland, J M1 aHilibrand, A S1 aVaccaro, A R1 aAlbert, T J  uhttps://www.notifylibrary.org/reference/1409