PREPARE FOR SURGERY
If a physician recommends surgery, a person should feel comfortable with the doctor and with the doctor’s recommendation. It is important to ask a doctor about different treatment options and share feelings about each of them. Discuss the risks, benefits, and alternative treatments. If a person doesn't feel comfortable with the recommendation of surgery, they should get a second opinion.
It also may be helpful to talk with patients who have had similar surgery. Ask a doctor if it is possible to arrange a conversation with another patient.
Here is some information on spinal fusion and the orthopaedic procedure.
UNDERSTANDING a SPINAL FUSION PROCEDURE
Spinal bone grafts may be implanted during surgery to fuse bones in the spine (vertebrae). A surgeon may access the spine through a cut (incision) in the abdomen (called an anterior approach), the side (called a lateral approach) or the back (called a posterior approach). A doctor may also implant a device through the same opening. Another option is to use a laparoscope. This scope allows the surgeon to see the spine with a camera through one small hole and perform the surgery through several other small holes. This is known as a laparoscopic surgical approach. A surgeon may use one of these techniques or another technique. A person should speak with a doctor about the risks and benefits of these techniques prior to surgery.
WHAT TO EXPECT DURING SPINAL FUSION SURGERY
During surgery, a doctor will remove portions of the degenerated disc and vertebral body to allow placement of the fusion device(s). The surgeon may choose to take bone from a hip or 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 the disc space. A surgeon may also choose to place devices into the rear portion of the vertebral bodies. Bone grafting may also be put into the devices in the back of your spine. A person should speak with a 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 the outcome. Additional surgery may be required 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
- Localised 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 anaesthesia 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
A person should tell their doctor immediately if they do not feel well after surgery, particularly if they are experiencing pain, fever, nausea and vomiting, infection, inflammation, redness or rash, itching, tenderness or swelling of the skin or surgery site. A doctor or nurse should be notified immediately if there is anything making the patient feel unwell, even if it is not on this list.
UNDERSTANDING the ORTHOPAEDIC PROCEDURE
There are numerous orthopaedic procedures that may require a surgeon to use bone graft in addition to the device(s) to stabilise or correct a 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 stabilise the injured area. The type of device(s) used by a surgeon will depend on the site of the injury in the body.
WHAT TO EXPECT DURING AN ORTHOPAEDIC PROCEDURE
During surgery, a doctor will adjust and realign the bones near the injury and place a device(s) that will provide immediate support to the injury. These devices can be metal screws, metal plates, metal rods and sometimes even completely new joints. A surgeon places bone graft near the inserted device(s) to help the body heal the injury or condition that is being treated. There are many types of orthopaedic procedures and a person should speak to a surgeon about the specific technique and materials, both devices and bone graft, that will be used in the 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 outcome. Additional surgery may be required 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 anaesthesia or the surgical approach
- Swelling
- Vascular problems other than bleeding
A person should tell their doctor immediately if they do not feel well after surgery, particularly if they are experiencing pain, fever, nausea and vomiting, infection, inflammation, redness or rash, itching, tenderness or swelling of the skin or surgery site. A doctor or nurse should be notified immediately if there is anything making the patient feel unwell, even if it is not on this list.
