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Surgery Coming In June

Mindymork62MMindymork62 Posts: 207
edited 06/11/2012 - 8:44 AM in Back Surgery and Neck Surgery
Hi Everyone,

I am finally getting surgery on June 29th for a 3 level fusion on my lower back. I was also told that an Orthopedic Dr. will also be doing the surgery with my neurosurgeon. I believe I'm suppose to have a bone graft taken from my hip. I have heard that the bone graft can also be taken from a cadaver. Can I request that from the Ortho Dr., or do I not have a choice? Both of these surgeons operated on my 35 year old daughter last August and she is doing great.Only problem I have is Osteopenia and my Dr.s are aware of this and moving cautiously by building up my bone mass before the surgery. I remember when my daughter had her surgery she was in "allot" of pain in her hip afterwards from the bone graft which they took from her hip.


  • Mindy, I haven't had a graft from my own body (called an autograft), my cervical graft was an allograft from cadaver bone. It is treated and sterilized and is not living bone; rather, it serves as a matrix for your own new bone to grow onto.

    From what I have been told by patients that have had autografts, they can be extremely painful to recover from. I'm surprised that your doctors want to harvest bone from you, since you have pre-osteoporosis, but I'm sure they know more about your condition than we can know from your post.

    I would say that you have the absolute right to request that an allograft be used (also called "donor bone"). If it were me I would do so, but perhaps your doctors are thinking something that they haven't expressed to you (yet). In any case, I would call your primary surgeon, which sounds like your neurosurgeon, and make you request. If you feel strongly, please don't be afraid to express that to him. If he insists that your own bone would be better, ask him to explain why.

    I hope your surgery works out well for you. Keep us posted!
  • I would be asking why the need for autograft also. I don't think it is used that much any more as it does cause a lot of pain in many patients. There must be a reason. Maybe your doctor has just had good results with it. How old is your doctor?
  • Bkins is right, a lot of surgeons have their own way of doing things and so may not give it a second thought. But as someone who has osteopenia, it is in your best interest to get up and moving right after your surgery both to heal the surgical site and to build/maintain your bone density. The pain from a bone graft may make it much more difficult to do so.

    Ask until you get answers. We care. :)
  • I have an autograph (my own bone) with my 360 fusion. But honestly, I don't have anything to compare it to. With a 360, you already have insicions posteriorly and anteriorly. At this point, what is another! :)

    I have not noticed a lot of graph pain. I have more pain from my skeletal frame getting out of aleignment from weakness, muscle inbalance, muscle spasms, and guarding.

    Wishing you the best!
  • Not too sure but if I had opted for a fusion (1-level), my doctor was going to use the crushed up Lamina from the vertabrae he had to cut to be able to clear out the rest of the disc. I supposed if you already had laminectomy that may not be an option but it's one worth asking about.

  • Yep, they often used cut up bone removed during your surgery to fill in the space where you will be fused, it gives new bone a structure to grown on. They may also use other materials, such as one called Infuse(tm), that also provides a support for growing bone tissue. Have you had prior surgery at this site? If so, there may not be enough "extra" bone that is removed during surgery, which is one reason why a doctor may use a graft from the patient's hip. It's worth asking your surgeon.

    Jayhawk, I can imagine the incisional pain from the anterior portion of the 360 (for those who don't know, this is surgery performed both through the abdomen and through the back) -- more tissue to go through, structures to deal with. I hope you're doing OK at this point and well on the way to recovery.
  • There are many reasons why a surgeon may elect to take your bone vs using cadaver bone. I myself have used my bone twice and looking at using it a third time along with the use of bmp(bonemorephgenic protein). The one thing about bmp is the FDA guide lines provide it is only to be used in a single level fusion and not in the cervical spine. Sense your having a three level fusion I am not sure they could use the product according to the guide lines, although some surgeons own their own centers and go around using it off label. As far as the bone grafting and pain following it, depends on wether it is anterior or posterior taken. I can honestly say the anterior was a bit harder to deal with but taken posterior was much easier on me physically following surgery. If they are going to have you on your stomach for the surgery I would check and see if that is possible. Also your surgeon maybe looking at the fact that multi level fusions have a higher failure rate on fusing, which is why he is looking at your bone. The bone they take from the hip is off the top of the illac crest and it is not that much at all. But if it were me I would do whatever it took to be in pain for a extra few weeks, rather than risk a future surgery from not fusing. Although all my surgery is cervical and not lumbar, I have had psuedo and the repeat surgery was no fun, to have gone so far and have it all come back and start again. I would also suggest that you ask if he is using your bone along with any other grafting material. One thing is by chance if your smoker, he maybe taking the extra added precaution of using your bone with the multi-level fusion odds to boot.
  • Hi, I just had PILF on L4/L5 with autograft from my own hip. I have not found it to be more painful than my incision or the swelling I'm having around the incision. My operation was one week ago 5/19/2010. It was explained to me that using your own bone was better than cadaver bone because you have a better chance of a match and fusing. So the decision is most definently up to you. Good luck.

    Mel v. O:)
  • The reason I ask about the difference in the bone graft and where it comes from is not because of the pain but mostly because I have Osteopenia, and had a bad fracture of my T12 vertebra in November. I had Kyphoplasty, but I still have some pain. I have to go see a Orthopedic Surgeon before I have surgery, because he works right along side of my Neurosurgeon doing the surgery. The Ortho. handles the "bone" part of it.
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