title: Anatomic feasibility of a new endopelvic approach for iliac crest bone harvesting.
abstract: OBJECTIVE
  For the past few years, anterior exposure for surgery of the lumbar spine has gained popularity for the treatment of disk disease or spondylosis. Cancellous bone remains the gold standard for fusion. Iliac crest bone harvesting is safe but there are donor site complications. Bone substitutes exist, like recombinant human bone morphogenic protein-2 rhBMP-2. This alternative offers a high rate of fusion but with local and general complications. The aim of our study is to show the feasibility of an endopelvic approach for iliac bone crest harvesting to avoid donor site complication.
  
  
  METHODS
  Twenty anterior retroperitoneal lumbar spine approaches have been realized in the anatomy department of the University of Bordeaux. The volumes of cancellous bone have been measured and procedure complications have been reported.
  
  
  RESULTS
  The mean volume of cancellous bone was 5.9 cc, the maximum volume was 8.2 cc and the minimum volume was 4.5 cc. No complications have been reported during the approach or the bone harvesting.
  
  
  CONCLUSIONS
  Anterior retroperitoneal approach for iliac bone crest harvesting is a safe way to obtain sufficient volume of cancellous bone for a single lumbar spinal fusion. This exposure avoids the risks of an iliac crest donor site complications or rhBMP-2 complications.
authors.affiliation: Regional Spine Institute, University Hospital of Rouen, Rue de Germont, 76000, Rouen, France. sebastien.lepape@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Le Pape
authors.affiliation: Urology Department, University Hospital of Rouen, Rouen, France.
authors.forename: L
authors.initials: L
authors.lastname: Du Pouget
authors.affiliation: Spine Unit 1, University Hospital Pellegrin, Bordeaux, France.
authors.forename: T
authors.initials: T
authors.lastname: Cloche
authors.affiliation: Spine Unit 1, University Hospital Pellegrin, Bordeaux, France.
authors.forename: M
authors.initials: M
authors.lastname: Campana
authors.affiliation: Spine Unit 1, University Hospital Pellegrin, Bordeaux, France.
authors.forename: I
authors.initials: I
authors.lastname: Obeid
authors.affiliation: Spine Unit 1, University Hospital Pellegrin, Bordeaux, France.
authors.forename: L
authors.initials: L
authors.lastname: Boissiere
authors.affiliation: Spine Unit 1, University Hospital Pellegrin, Bordeaux, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Vital
mesh_terms: D000368:Aged; D055396:Bone Morphogenetic Protein 2 / Q000009:adverse effects / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D002102:Cadaver; D000071556:Cancellous Bone / Q000637:transplantation; D004210:Dissection; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008297:Male; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012187:Retroperitoneal Space; D013123:Spinal Fusion / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D016212:Transforming Growth Factor beta / Q000009:adverse effects / Q000627:therapeutic use*; D014182:Transplantation, Autologous / Q000009:adverse effects / Q000379:methods
chemical_list: D055396:Bone Morphogenetic Protein 2; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2
keywords: Bone graft; Endopelvic approach; Iliac crest; Interbody fusion; Lumbar spine surgery