Postmortem evaluation of neuromuscular damages more extensive than the surgical intervention area after iliac crest bone graft.
Surg Radiol Anat
; 43(6): 827-831, 2021 Jun.
Article
in En
| MEDLINE
| ID: mdl-33399921
ABSTRACT
Several complications may occur following iliac bone grafting, one of the common sites for autologous bone harvesting. Of these, it is difficult to localize the damage in neurological complications due to the presence of several nerves in a similar distribution area with variations among individuals. To minimize these complications, conventional clinical anatomical studies using normal human cadavers have estimated the theoretical neurological damage area corresponding to the surgical intervention area. We report a case of neuromuscular damage in a 93-year-old woman who had an iliac crest defect after a bone graft, based on the virtual and physical dissections with histological confirmations.In this study, the patient was confirmed to have severe neuromuscular complications with major complications including a hernia protruding through the iliac defect. One of the two ilioinguinal nerves was extracted with the hernia sac through the iliac defect, and its distal part was completely damaged. The iliohypogastric nerve, which was far from the defect foramen, also showed remarkable fibrosis and demyelination, affected by the degeneration of the transversus abdominis muscles.The present anatomical findings show that the area of eventual neuromuscular damage should be estimated to larger than the conventionally predicted area of direct nerve damage, which is usually concomitant with the surgical intervention area.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Tissue and Organ Harvesting
/
Hernia
/
Ilium
/
Lumbosacral Plexus
Type of study:
Etiology_studies
/
Prognostic_studies
Limits:
Aged80
/
Female
/
Humans
Language:
En
Journal:
Surg Radiol Anat
Journal subject:
ANATOMIA
/
RADIOLOGIA
Year:
2021
Document type:
Article
Affiliation country: