title: Complete pelvic ring failure after posterior iliac bone graft harvesting.
abstract: METHODS
  Case report.
  
  
  OBJECTIVE
  To present a rare complication of posterior iliac bone graft harvesting.
  
  
  BACKGROUND
  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.
  
  
  METHODS
  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.
authors.affiliation: Cornell University Medical College, Ithaca, New York, USA.
authors.forename: T L
authors.initials: TL
authors.lastname: Fernando
authors.forename: S S
authors.initials: SS
authors.lastname: Kim
authors.forename: D G
authors.initials: DG
authors.lastname: Mohler
mesh_terms: D016025:Bone Transplantation; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D007085:Ilium / Q000000981:diagnostic imaging / Q000293:injuries / Q000637:transplantation*; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000000981:diagnostic imaging; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D012086:Reoperation; D014057:Tomography, X-Ray Computed
chemical_list: D005938:Glucocorticoids