Name of the Procedure:

Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision)

Summary

An autograft for spine surgery involves taking a small piece of bone from the patient’s own body (typically the hip) to use in spine surgery. The bone is ground into small pieces, known as morselized bone, and then used to aid in the healing and fusion of the spine. This procedure involves making a separate incision to harvest the bone graft.

Purpose

This procedure addresses conditions like spinal instability, deformities, or degenerative disc disease. The goal is to enhance spinal fusion, stabilize the spine, and alleviate pain, allowing for improved function and mobility.

Indications

• Chronic back pain unresponsive to other treatments
• Spinal instability or deformity
• Degenerative disc disease
• Spondylolisthesis
• Patients needing spinal fusion to stabilize the spine

Preparation

• Fasting typically required 8-12 hours before surgery.
• Medication adjustments might be needed, such as stopping blood thinners.
• Preoperative assessments, including imaging studies (MRI, CT scan) and blood tests.

Procedure Description

1. Anesthesia: Patient is placed under general anesthesia.
2. Harvesting the Graft: A separate incision is made over the donor site, often the iliac crest of the hip.
3. Bone Collection: The surgeon removes a small portion of bone, which is then ground into small particles.
4. Spinal Surgery: The during the primary spine surgery, the morselized bone graft is applied to the surgical site to promote bone fusion.
5. Closure: Both the donor site and spine incision are closed with sutures or staples.

Tools: Surgical scalpel, bone graft harvesting instruments, bone morselizer. Equipment: Imaging guidance systems, surgical tables, anesthesia equipment.

Duration

The entire process, including harvesting and spine surgery, typically takes 3-6 hours.

Setting

This procedure is performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic or neurosurgeons
• Anesthesiologists
• Surgical nurses
• Scrub technicians

Risks and Complications

• Donor site pain or infection
• Bleeding or hematoma
• Injury to surrounding tissues or nerves
• Non-union or failure of spinal fusion
• General surgical risks such as anesthesia complications

Benefits

• Enhances spinal fusion success rates
• Uses patient’s own bone, reducing risk of rejection or disease transmission
• Alleviates chronic back pain and improves mobility
• Promotes long-term spinal stability

Recovery

• Hospital stay of 2-5 days post-surgery.
• Instructions include wound care, activity restrictions, and physical therapy.
• Full recovery can take 6-12 months, with gradual return to normal activities.
• Regular follow-up visits for monitoring progress.

Alternatives

• Allograft (donor bone) or synthetic graft materials
  • Pros: No additional incision, reduced donor site morbidity.
  • Cons: Potential for rejection, inferior healing compared to autograft.
• Nonsurgical options: physical therapy, pain management, or less invasive procedures.
  • Pros: Lower risk, conservative treatment.
  • Cons: May not provide long-term relief or correction of the spinal condition.

Patient Experience

Patients may experience postoperative pain at both the surgical and donor sites, managed by pain medications and comfort measures. Activity limitations and physical therapy are necessary to ensure proper healing. Pain and discomfort typically improve over several weeks.