Evaluating post-operative pain management at the iliac crest bone graft site: an editorial

Uzondu F. Agochukwu, John G. DeVine


As academicians and spine surgeons, we appreciate the effort and time required to plan and execute a randomized clinical trial (RCT). Given the current medical climate and importance of evidence-based medicine, the RCT is the gold-standard and for this reason alone, we applaud the authors, Samartizis et al. (1) in their pursuit of evidence-based knowledge. To summarize, Samartizis et al. aimed to examine the effect of postoperative pain management at the iliac crest bone graft (ICBG) site in patients undergoing surgery for adolescent idiopathic scoliosis (AIS). The goal was to assess the ability to affect post-operative pain in patients undergoing ICBG for scoliosis surgery. They performed a randomized, prospective study in which the treatment group was given a continuous local anesthetic infusion at the ICBG site while the control group received a continuous infusion of saline. The infusions were administered for 47 hours. There were five patients in the treatment group and seven patients in the control group. There were no differences in demographic between the two groups. There were no differences in regards to type of curve, levels fused, or length of hospitalization. They recorded changes in pain according the visual analog scale (VAS) at the surgical site, ICBG site, and contralateral ICBG site. Pain was recorded until post-operative day 4, at which time the patients were discharged.