ILIAC CREST BONE-GRAFT - OSTEOTOME VERSUS SAW

The strength of saw-harvested vs. osteotome-harvested Smith-Robinson i liac crest grafts from five fresh frozen cadavers was compared. Matche d pairs of grafts were harvested, one with a saw and the other with an osteotome from equivalent locations on the two iliac crests of each p elvis. Grafts were tested to failure in axial compression, and load-di splacement curves were recorded for each test. Yield load and displace ment, ultimate load, and stiffness were calculated, and statistical an alysis was performed with the Student t test and three-way analysis of variance. Evaluation of the 66 pairs of grafts revealed that saw-harv ested grafts were consistently stronger then were matched grafts harve sted with an osteotome. The middle third of the iliac crest produced s ignificantly stronger grafts, and those harvested from younger donors were significantly stronger than those obtained from older donors. Of even greater clinical relevance, saw-harvested grafts were stiffer tha n osteotome-harvested grafts. Based on these findings, it is recommend ed that iliac crest grafts harvested for spine fusion be obtained with an oscillating saw rather than with an osteotome.