Name of the Procedure:

• Common Name: Bone Harvesting
• Technical/Medical Term: Harvest the bone for use in autogenous grafting (HCPCS: D7295)

Summary

Bone harvesting is a surgical procedure where a small portion of bone is removed from one area of the patient's body to be used in another area that requires bone grafting. This autogenous grafting relies on the patient's own bone to stimulate healing and bone growth in the target area.

Purpose

The primary purpose of bone harvesting for autogenous grafting is to address conditions where bone is missing, damaged, or deficient. This may include facial reconstruction, dental implants, or spinal fusion surgery. The goal is to promote bone regeneration and structural support using bone from the patient’s own body, which is less likely to be rejected compared to synthetic or donor grafts.

Indications

• Large defects in the jaw or facial bones
• Dental implants requiring additional bone support
• Spinal surgeries needing bone fusion
• Repair of bone loss due to trauma or disease
• Non-healing fractures

Preparation

• Pre-procedure Instructions: Patients may be asked to fast for several hours before the procedure. Medication adjustments, such as stopping blood thinners, may be necessary.
• Diagnostic Tests: Pre-surgical imaging like X-rays, CT scans, or MRIs to assess bone structure and plan the harvest site.

Procedure Description

1. Anesthesia: The patient is usually given general anesthesia or sedation to ensure comfort throughout the procedure.
2. Incision: A small incision is made at the donor site (e.g., the hip, jaw, or chin) where bone will be harvested.
3. Harvesting: Using surgical tools, the surgeon removes a small section of bone.
4. Grafting: The harvested bone is then shaped and placed into the defect or graft site.
5. Closure: The incisions at both the donor site and graft site are closed with sutures.

Tools used include surgical drills, chisels, and bone grafting instruments.

Duration

The procedure typically takes 1 to 2 hours, but this can vary depending on the complexity and size of the graft required.

Setting

Bone harvesting is generally conducted in a hospital or a specialized surgical center equipped for such procedures.

Personnel

• Surgeon: Performs the procedure
• Nurses: Assist during the procedure and in post-operative care
• Anesthesiologist: Manages anesthesia and monitors the patient’s vital signs

Risks and Complications

• Common Risks: Infection, bleeding, pain at the donor or graft site
• Rare Complications: Nerve damage, blood clots, delayed healing
• Management may involve antibiotics for infection or additional surgery for complications.

Benefits

• Expected Benefits: Enhanced healing and bone regeneration, improved structural integrity at the graft site.
• Realization Time: Typically visible in a few months as the bone integrates and heals.

Recovery

• Post-Procedure Care: Pain management with medication, keeping incision sites clean and dry, minimal physical activity.
• Recovery Time: Generally 4 to 6 weeks for initial recovery, with full bone integration taking several months.
• Follow-Up: Regular appointments to monitor healing and graft success.

Alternatives

• Synthetic Bone Grafts: Less risk of infection but potentially less effective in some cases.
• Donor Bone Grafts: Risk of rejection or disease transmission.
• Bone Substitute Materials: Varying success rates and biological compatibility.

Pros and cons of alternatives depend on the specific medical condition, patient health, and expected outcomes.

Patient Experience

• During the Procedure: The patient will be under anesthesia and will not feel pain.
• After the Procedure: Pain and swelling at both the donor and graft sites. Pain is managed with prescribed medications.
• Comfort Measures: Ice packs, rest, and limited physical activity help manage discomfort and promote healing.