Advantages of percutaneous hollow needle technique for iliac bone harvest in alveolar cleft grafting

Objective: To evaluate the percutaneous hollow needle technique for bone ha rvest to determine if morbidity from the bone donor site can be reduced sig nificantly. Methods: A retrospective chart review was performed evaluating all patients undergoing alveolar bone grafting at our institution from January 1992 thr ough December 1996, Patients who underwent additional major procedures were excluded. Group I consisted of 12 patients in whom the percutaneous techni que was utilized. The patients had an average age of 11.1 years (range: 8 t o 15 years). Six were male and six were female, One had a bilateral cleft, Group II consisted of 15 patients in whom the conventional open technique f or iliac crest bone harvest was used. They had an average age of 13.1 years (range: 7 to 31 years). Six were male and nine were female, Two had bilate ral clefts. Minimum follow-up was 6 months. We evaluated intraoperative blo od loss, total postoperative analgesia requirement, and length of hospital stay based on a retrospective hospital chart review. Results: A significant difference was found between the two groups regardin g intraoperative blood loss (group I: 83.3 cm(3), group II: 208 cm(3); p =. 0015), postoperative total analgesia requirement (group I: 0.04 mg/kg, rang e: 0 to 0.17 mg/kg; group II: 0.34 mg/kg, range: 0.03 to 0.74 mg/kg; p.0002 ), and length of hospital stay (group I: 1.0 days, group II: 2.13 days; p = .0001). There was no significant change in these results when bilateral cl efts were excluded. Conclusion: Iliac bone graft harvest using the percutaneous hollow needle t echnique results in less blood loss, decreased postoperative pain, and shor ter hospital stays compared with the open technique.