title: Spinopelvic dissociation as a complication of iliac crest bone graft harvest using an acetabular reamer.
abstract: METHODS
  Descriptive case report.
  
  
  OBJECTIVE
  To report spinopelvic dissociation as a complication of autogenous bone graft harvest with the use of an acetabular reamer.
  
  
  BACKGROUND
  Iliac crest bone graft harvest has been previously described in orthopedic literature with overall complication rates of 0% to 39%. Complications are inconsistently separated into "minor" and "major" groups, commonly reporting hematoma, infection, and injury to the superior gluteal artery or nerve. No reports of spinopelvic dissociation, a well known injury in the traumatic setting, have been reported.
  
  
  METHODS
  We report the case of 1 patient who presented with spinopelvic dissociation after autogenous bone graft harvest with the use of an acetabular reamer.
  
  
  RESULTS
  We present a unique case in which fracture through the reamer harvesting site led to complete disruption of the posterior pelvic ring on the operative side. Subsequent attempted closed management led to failure through the osteoporotic anterior pelvic ring on the operative side and the posterior pelvic ring on the contralateral side, leading to progressive instability, disability, and pain. This was successfully addressed with lumbopelvic fusion and 2-year follow-up is presented.
  
  
  CONCLUSIONS
  The potential hazard of acetabular reamer bone graft harvest is discussed, and primary operative fixation of harvest-related fractures is suggested.
authors.affiliation: Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Higgins
authors.forename: David L
authors.initials: DL
authors.lastname: Rothberg
authors.forename: Michael D
authors.initials: MD
authors.lastname: Daubs
mesh_terms: D000077:Acetabulum / Q000293:injuries* / Q000601:surgery*; D016025:Bone Transplantation / Q000009:adverse effects*; D005260:Female; D050723:Fractures, Bone / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007085:Ilium / Q000293:injuries* / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D016896:Treatment Outcome