Communication about incisional hernia through an iliac crest bone harvest site after reoperative cervical anterior fusion

Abstract

We report the case of an incisional hernia through the wound made for iliac bone harvest for re-operative cervical fusion surgery. A 50-year old woman underwent revision anterior cervical discectomy and fusion (ACDF) using a poly ether ether ketone cage and titanium alloy locking plate for adjacent segment disease after prior ACDF. As an autograft, iliac cancellous bone was again harvested from the left iliac crest, using the prior surgical scar. Although only cancellous bone from the medial side of the iliac bone was collected, leaving the iliac crest intact, she complained of a protrusion from the left lower abdomen, of which diagnosis was an incisional hernia through the iliac bone harvest site. Formation of an incisional hernia at the iliac bone harvest site is a possible complication after spine surgery. Care must be taken for oblique abdominal muscle repair around the iliac bone harvest site, particularly in re-operative cases. Keywords: Incisional hernia, Iliac crest, Bone graft, Spinal fusion surgery