PubMed · 8371873
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R F Zambito. Proof lacking.. https://pubmed.ncbi.nlm.nih.gov/8371873/
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STUDY DESIGN: A morphologic study of the anterior part of the iliac crest was performed. OBJECTIVE: To define the anatomic characteristics of the anterior part of the ilium and to determine an optimal area to harvest the iliac bone graft from the anterior iliac crest. SUMMARY OF BACKGROUND DATA: Stress fracture or avulsion fracture of the anterior cut for anterior iliac crest graft have been noted previously. However, there is insufficient published information on the morphology of the anterior part of the ilium relative to the optimal location of harvesting the bone graft. METHODS: Direct measurements using digital calipers were taken from 30 dried human pelves and 10 cadaveric pelves. The thickness of the anterior part of the ilium was measured, with different starting points on the iliac crest. The length of the bicortical iliac bone graft also was determined. RESULTS: The thickest portion of the ilium was 18.9 +/- 2.3 mm at the iliac tubercle, which was 45% thicker than at a point 3 cm posterior to the anterior superior iliac spine. The thick region of the anterior iliac crest extended 54.0 +/- 10.2 mm posteriorly from a point 3 cm posterior to the anterior superior iliac spine. The mean length of a 10 mm thick bicortical iliac tubercle bone graft was 36.8 +/- 8.7 mm. CONCLUSIONS: The region around the iliac tubercle is suitable for harvesting bicortical or tricortical bone graft.
STUDY DESIGN: This is a report of a 63-year-old woman with a retrodental fibrocartilaginous mass and myelopathy. OBJECTIVE: To describe the pathophysiology of the retrodental fibrocartilaginous mass formation and its association with the C2-C3 disc. SUMMARY OF BACKGROUND DATA: High cervical disc protrusion is an uncommon condition and presents even more rarely as a craniovertebral junction mass with spinal cord compression. Uncertainty remains regarding the etiology of its formation in the retrodental region. METHODS: The patient underwent surgical intervention with transoral decompression and posterior C1-C2 skeletal fusion with bony graft. RESULTS: On the basis of dynamic plain radiographs, magnetic resonance imaging, and surgical pathology, the origin of the mass may have been the C2-C3 disc. CONCLUSIONS: We hypothesized that the mechanism underlying the posterior odontoid fibrocartilaginous mass with spinal cord involvement most likely originate upward migration of the C2-C3 annulus fragment to the atlantoaxial joint as a result of aging. Secondary fibrocartilaginous metaplasia plays a major role in creating such disc-like material. To prevent unrecoverable myelopathy, early detection and anterior decompression with posterior C1-C2 skeletal fixation and bony fusion are the best treatment methods.