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Back Surgery Patients May Overestimate Graft Site Pain

Bone graft pain may actually be due more to spinal surgery than bone harvest

THURSDAY, Aug. 9 (HealthDay News) -- Patients who undergo low-level spinal fusion operations using bone grafts from the iliac crest probably cannot distinguish between postoperative pain originating at the graft site and pain originating at the primary surgery site, according to a report published in the Aug. 1 issue of Spine.

Diyar Delawi, M.D., of the University Medical Center Utrecht in the Netherlands, and colleagues reviewed questionnaires completed by 71 patients (69 percent men; mean age 47.6 years) who had received posterolateral fusion with autologous bone grafts from the posterior iliac crest. The mean follow-up period was 7.3 years.

Patients whose fusion levels included L3 or below attributed pain to the donor site significantly more often than patients whose fusions levels were higher than L3 (40.9 percent in the lower group versus 14.3 percent in the higher group). Of patients in the higher group who did report postoperative pain, 71 percent graded the pain as mild.

"We postulate that spinal trauma patients who undergo fusion cranial to level L3 are probably a suitable population to evaluate the true incidence of donor site pain after posterior iliac crest bone harvesting," the authors conclude, "while results on iliac crest donor site pain from patients that underwent a fusion below this level should be interpreted with caution."

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