Delayed iliac crest autograft fractures following plated single-level anterior cervical corpectomy with fusion

Recurrent cervical pain following single-level plated anterior corpectomy with fusion signaled delayed mid-iliac crest autograft fractures in four of 56 patients. Single-level anterior corpectomy with fusion used 15 fixed plates (Sofamor Danek) and 41 dynamic ABC plates (Aesculap). Patients in the fixed-plate and dynamic-plate groups averaged 46 and 48 years of age, respectively. Fusion was confirmed on both dynamic radiograph and two-dimensional CT studies an average of 4.5 months postoperatively. Two (13%) fixed-plated patients developed mid-iliac crest strut fractures 1 and 2 years postoperatively, whereas two (5%) dynamic-plated patients showed similar fractures 6 and 9 months following surgery. Immobilization in CTO orthoses resulted in fusion in one case, whereas three patients required secondary posterior wiring/fusion. Recurrent pain signaled delayed autograft strut fractures in four of 56 patients undergoing plated single-level anterior corpectomy with fusion.