Which nerve is most commonly injured in anterior iliac crest bone grafting (AICBG)?

The iliohypogastric nerve is most commonly injured during anterior iliac crest bone grafting due to its anatomical location and the surgical approach used in these procedures. This nerve typically arises from the L1 spinal nerve and runs along the upper part of the ilium, making it susceptible to injury when an incision is made to harvest bone from the iliac crest.

During the surgical procedure, the incision is often made over the iliac crest to access the bone for grafting. The iliohypogastric nerve, being superficial and closely associated with the iliac crest, can be inadvertently transected or damaged during the dissection process. Injury to this nerve can lead to complications such as sensory loss in the abdominal wall and potential issues with motor function, though its motor function is limited compared to other nerves in the region.

While other nerves such as the femoral, obturator, and lower sacral nerves also play roles in the hip and lower extremity function, they are not in close proximity to the iliac crest where grafting occurs and are thus less likely to be affected during this specific surgical procedure. This anatomical consideration underscores why the iliohypogastric nerve is the most frequently encountered nerve injury in the context of