Optimizing Safety of Iliac Bone Harvest Using an Acumed Drill: A Simulated Radiographic Study of 100 Patients

Objective:  To determine the potential risk of visceral injury during Acumed drill iliac crest cancellous bone graft harvest. Design:  Radiographic iliac crest anatomic analysis with simulated drill course to measure cancellous bone available for harvest and proximity of vulnerable pelvic structures. Setting:  Single institution, tertiary care university hospital. Patients and Participants:  One hundred pelvic computed tomography scans performed on children 8 to 12 years old without traumatic or neoplastic pathology. Interventions:  Radiographic simulation of Acumed drill course within iliac bone. Main Outcome Measures:  (1) Potential for pelvic visceral injury. (2) Volume of cancellous bone safely available for harvest. Results:  Superior and medial cortical thickness at the reference point remained stable across age groups; however, lateral cortical thickness increased with age (3.13 to 3.74 mm, P < .001). Cancellous bone width increased with age at all depths measured (P < .001). Through radiographic s...