Adverse Events Associated with Iliac Crest Bone Graft for Spinal Fusion

Use of iliac crest bone grafts for spinal fusions led to increased length of hospital stay, increased postoperative blood transfusions and extended operative times, according to study findings.

Researchers from Yale University and Yale School of Medicine conducted a retrospective study using the American College of Surgeons National Surgical Quality Improvement Project 2010-2012 database, analyzing data for 13,927 patients who underwent spinal fusion. Among these cases, 820 included the use of iliac crest bone grafts (ICBGs).

The researchers reviewed demographics, comorbidities, surgical data and both hospital and 30-day follow-up outcomes, which included adverse events, length of hospital stays and rates of readmission.

Patients in whom ICBGs were used were more likely to have a postoperative blood transfusion compared with patients in whom the grafts were not used. Additionally, patients in the ICBG cohort had longer operative times and extended lengths of hospital stay, according to the researchers.

Upon completing multivariate analyses in which the researchers controlled for comorbidities, demographics and approach, the Yale researchers confirmed that use of ICBGs was significantly associated with postoperative blood transfusion, extended operative time and increased length of stay.

Other outcomes such as infection, return to the operating room and deep vein thrombosis were not changed by use ICBG, according to the researchers.