Purpose: To compare the post-operative morbidity, of a novel vertical approach, with that of the standard transverse one, for procurement of Autologous bone graft from the iliac crest, for the purpose of cervical spine fusions.

Methodology: Patients undergoing procurement of bone graft from the iliac crest were prospectively randomised into two groups. The study group (18) underwent the procedure through a novel vertical approach, while the controls (22) had the standard transverse approach. Both groups were evaluated by a blinded observer at 1 month and 6 months postoperatively. The visual analogue pain score,(VAS), use of analgesics, disruption of cutaneous nerve function and local tenderness were recorded.

Results: The mean VAS in the study group was 2.5 and 4.4 in the control group one month postoperatively. This was reduced to 2.9 in the control group and 1.8 in the study group six months later. The study group had a lower incidence of local numbness (33.3 %) compared to (72.7%) in the control group one month after surgery. Use of analgesia after 6 months was lower in the study group (11.1%), compared to 50% in the control group 6 months post operatively. There was no significant difference between the two groups with regards to other parameters.

Conclusion: The vertical approach to the iliac crest is associated with lower morbidity and is an effective alternative to the standard approach.