Complete pelvic ring failure after posterior iliac bone graft harvesting.

STUDY

DESIGN

Case report.

OBJECTIVE

To present a rare complication of posterior iliac bone graft harvesting.

SUMMARY OF BACKGROUND DATA: Although iliac bone graft harvesting is a common procedure in spinal surgery, it is not without complications. One such complication is fracture of the ilium that is seen most often in older women with osteopenia.

METHOD: In this case a severe complication of posterior iliac bone graft harvesting was identified in a patient with steroid-induced osteoporosis that led to multiple pelvic fracture, nonunions, and eventual failure of the entire pelvic ring. Imaging studies showed osteoporotic bone and multiple nonunions of the pelvis with structural collapse.

RESULTS

Staged sequential platings of the iliac wings were performed to stabilize the pelvis. The initial fixation of the left iliac wing apparently united after hardware failure. The right iliac wing was successfully fixed with plates supplemented with bone cement and allograft. Anterior fixation was planned.

CONCLUSIONS

Care should be taken when considering autograft harvesting in patients with risk factors for osteoporosis. The outcome could be debilitating.