title: Reconstruction versus no reconstruction of iliac crest defects following harvest for spinal fusion: a systematic review: A review.
abstract: OBJECTIVE
  Autologous bone from the iliac crest is commonly used for spinal fusion. However, its use is associated with significant donor site morbidity, especially pain. Reconstructive procedures of the iatrogenic defect have been investigated as a technique to alleviate these symptoms. The goal of this study was to assess the effects of reconstruction versus no reconstruction following iliac crest harvest in adults undergoing spine surgery.
  
  
  METHODS
  The authors searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2011, Issue 4); MEDLINE (1948-Oct 2011); EMBASE (1947-Oct 2011); and the reference lists of articles. Randomized controlled trials (RCTs) or nonrandomized controlled trials (NRCTs) were included in the study. Two independent reviewers selected the studies, extracted data using a standardized collection form, and assessed for risk of bias.
  
  
  RESULTS
  Three RCTs (96 patients) and 2 NRCTs (82 patients) were included. These had a moderate to high risk of bias. The results suggest that iliac crest reconstruction may be useful in reducing postoperative pain, minimizing functional disability, and improving cosmesis. No pattern of other clinical, radiological, or resource outcomes was identified.
  
  
  CONCLUSIONS
  Although the available evidence is suboptimal, this systematic review supports the notion that iliac crest reconstruction following harvest for spinal fusion may reduce postoperative pain, minimize functional disability, and improve cosmesis.
authors.affiliation: Department of Neurosurgery, Royal Prince Alfred Hospital, University of New SouthWales, Sydney, Australia.
authors.forename: Anthony M T
authors.initials: AM
authors.lastname: Chau
authors.forename: Lileane L
authors.initials: LL
authors.lastname: Xu
authors.forename: Rhys
authors.initials: R
authors.lastname: van der Rijt
authors.forename: Johnny H Y
authors.initials: JH
authors.lastname: Wong
authors.forename: Cristian
authors.initials: C
authors.lastname: Gragnaniello
authors.forename: Ralph E
authors.initials: RE
authors.lastname: Stanford
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Mobbs
mesh_terms: D016025:Bone Transplantation / Q000379:methods*; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013123:Spinal Fusion / Q000379:methods*; D014182:Transplantation, Autologous