During Surgery Bone Grafting (Spine and Orthopaedic)

PREPARE FOR YOUR SURGERY

If your physician recommends surgery, make sure you feel comfortable with your doctor and your doctor’s recommendation. Ask your doctor about different treatment options and share what you think and feel about each of them. Discuss the risks, benefits, and alternative treatments. If you don't feel comfortable with the recommendation of surgery, get a second opinion.

It also may be helpful for you to talk with patients who have had the surgery you’re considering. Ask if your doctor can arrange a conversation between you and another patient.

Here is some information on the spinal fusion procedure and the orthopaedic procedure to get you started.


 UNDERSTANDING YOUR SPINAL FUSION PROCEDURE

Spinal bone grafts may be implanted during the surgery to fuse bones in your spine (vertebrae). Your surgeon may access your spine through a cut (incision) in your abdomen (called an anterior approach), your side (called a lateral approach) or your back (called a posterior approach). Your doctor may also implant a device through the same opening. Another option is to use a laparoscope. This scope allows the surgeon to see your spine with a camera through one small hole and perform the surgery through several other small holes. This is known is a laparoscopic surgical approach. Your surgeon may use one of these techniques or another technique. You should speak with your doctor about the risks and benefits of these techniques prior to surgery.

WHAT TO EXPECT DURING SPINAL FUSION SURGERY

During your surgery, your doctor will remove portions of the degenerated disc and vertebral body to allow placement of the fusion device(s). Rather than taking bone from your hip, the surgeon will use a bone graft along with the fusion device(s). The bone graft can be packed into the hollow implants called interbody fusion devices. The graft-packed interbody fusion device(s) is then implanted into your disc space. Your surgeon may also choose to place devices into the rear portion of your vertebral bodies. Bone grafting may also be pack near the devices in the back of your spine. You should speak with your surgeon about the risks and benefits of the bone grafts that will be used.

As with any surgery, spinal surgery is not without risk. A variety of complications related to either the surgery or bone graft can occur. These may occur singly or in combination. Some of these may be severe, affecting your outcome. You may also need to have additional surgery to correct these complications.

Some of the possible complications include:

  • Allergic reaction to the implant materials
  • Bending, breakage, loosening, and/or migration of the implants
  • Bleeding, which may require a blood transfusion
  • Bone fracture or failure to fuse
  • Bone formation that is abnormal, excessive, or in an unintended location
  • Bone resorption, which may not be permanent
  • Bowel, bladder, or gastrointestinal problems
  • Damage to nearby tissues
  • Death
  • Fetal development complications
  • Infection
  • Localized swelling (edema) or collection of fluid near the implant site
  • Pain or discomfort
  • Paralysis or other neurological problems
  • Postoperative changes in spinal curvature or loss of correction or disc height
  • Respiratory (breathing) problems
  • Scar formation or other problems with the surgical incision
  • Sexual dysfunction
  • Side effects from anesthesia or the surgical approach
  • Spinal cord or nerve damage
  • Tears of the dura (a layer of tissue covering the spinal cord)
  • Vascular problems other than bleeding

You should tell your doctor immediately if you do not feel well after your surgery, particularly if you experience pain, fever, nausea and vomiting, infection, inflammation, redness or rash, itching, tenderness or swelling of the skin or surgery site. Tell your doctor or nurse if you notice anything else that is making you feel unwell, even if it is not on this list.


 UNDERSTANDING YOUR ORTHOPAEDIC PROCEDURE

There are numerous orthopaedic procedures that may require your surgeon to use bone graft in addition to the device(s) need to stabilize or correct your condition. Some of the common orthopaedic procedures that require bone grafting are: fusions of the bones of the foot or ankle, bunion repair, total joint revisions (knees, hips, ankles or shoulders) and fracture repair. Bone grafting is used in these procedures to help the body create new bone to permanently stabilize the injured area. The type of device(s) used by your surgeon will depend on the site of the injury in your body.

WHAT TO EXPECT DURING YOUR ORTHOPAEDIC PROCEDURE

During your surgery, the doctor will adjust and realign the bones near the injury and place device(s) that will provide immediate support of the injury. These devices can be metal screws, metal plates, metal rods and sometimes even completely new joints. Your surgeon places bone graft near the inserted device(s) to help your body heal the injury or condition that you are having treated. There are many types of orthopaedic procedures and you should speak to your surgeon about the specific technique and materials, both devices and bone graft, that will be used in your treatment.

As with any surgery, surgical treatment of a orthopaedic conditions is not without risk. A variety of complications related to surgery or the use of bone graft can occur. These may occur singly or in combination. Some of these may be severe, affecting your outcome. You may also need to have additional surgery to correct these complications. Some of the possible complications include:

  • Allergic reaction to the implant materials
  • Bending, breakage, loosening, and/or migration of the implant
  • Bleeding, which may require a blood transfusion
  • Bone fracture or failure to heal
  • Bone formation that is abnormal, excessive or in an unintended location
  • Bowel, bladder or gastrointestinal problems
  • Damage to nearby tissues
  • Death
  • Fetal development complications
  • Infection
  • Pain or discomfort
  • Paralysis or other neurological problems
  • Rash
  • Respiratory (breathing) problems
  • Scar formation or other problems with the surgical incision
  • Side effects from anesthesia or the surgical approach
  • Swelling
  • Vascular problems other than bleeding

You should tell your doctor immediately if you do not feel well after your surgery, particularly if you experience pain, fever, nausea and vomiting, infection, inflammation, redness or rash, itching, tenderness or swelling of the skin or surgery site. Tell your doctor or nurse if you notice anything else that is making you feel unwell, even if it is not on this list.