In Situ Spinal Fusion

How bone graft is used for In Situ spinal fusion

Bone graft is used to correct issues with bones and joints, the surgery is also referred to as bone tissue transplant. Bone grafting is essential especially to create stability in cases such as knee transplants for example which helps to allow the bone to grow around an implanted device.

The two main types of bone grafting include:

- An Allograft - bone from a cadaver or deceased donor is used,

- An Autograft - these bone grafts come from the patient's own body (hip, wrist, pelvis or wrist).

There are also other types which are sourced differently and more common in dentistry such as:

- Synthetic variants - made from ceramics to mimic true bone,

- Xenograft - from cattle (bovine),

- Alloplastic grafts - from natural metal.

Bone grafts are also often used in the process of facial and cranial reconstruction.

Spinal fusion surgery is sometimes performed to stop the spine from growing. The operation can be completed through the chest (anterior) or through the back (posterior). In the procedure, the joints of the spine are taken out and are replaced with a bone graft. As the bones heal, they fuse together to form one solid mass of bone. The goal of the surgery is to make several of the individual backbones (vertebra) become one section and stop growing crooked or curved out of alignment. Sometimes surgical implants such as screws, rods or hooks are inserted to act like an internal brace for the bones and the bone graft and to help slightly straighten the spine. In young children, implants might not be used, and the child may need to wear an external brace following surgery.

Patients may also need a bone graft if they have a bone disease, an injury that has not previously been treated, surgically implanted devices as well as a fracture that may not be able to heal without a bone graft procedure.

Advantages of bone grafts

The advantage of an in situ spinal fusion is that it can address the problem of a spinal curvature early before serious deformity occurs. For instance, if a spine specialist sees a child who has a 40-degree curvature that has a good chance of progressing, a limited spinal fusion may be recommended to prevent the curve from getting any worse.

In situ spinal fusion usually carries less risk than operations to correct a spinal curvature. The outcome of surgeries performed to correct curvatures on patients who are still growing is difficult to predict. This is because the spine is still growing, and as it grows in areas not affected by the curve, rotation or twisting of the spine can occur.

Spinal fusion is not recommended for every patient diagnosed with early onset scoliosis. It stops the growth in one section of the spine, so it can also prevent or slow the growth of the thorax, the part of the body that lies between the neck and the waist. This can cause thoracic insufficiency, a condition in which the walls of the chest cannot support adequate breathing.

Risks of bone grafts 

Bone grafting is a surgical procedure and even though it has many benefits it also poses risks which can be also expected from any surgical procedure or operation. Some of these risks may include:

- Bleeding,

- Infection,

- Infection from the donated bone or bone tissue source (rare),

- Complications due to anesthetic,

- Inflammation/swelling,

- Rejection of the bone graft,

- Nerve injury.

Symptoms and Diagnosing the need for bone graft surgery

Patients that possibly need bone graft surgery would usually exhibit server back pain and this is often related to spinal issues if it carries on for a long period of time or months. If the pain is elsewhere such as joints and other bones, then it can be related to injuries and other factors.
A number of factors will influence the type of bone graft procedure for spinal fusion for the patient when it comes to their spine and may include the following:

- The location of the fusion

- Spine level numbers

- Type of spinal fusion

- Risk factors of the patient

The doctor will do various diagnostics tests including scans such as X-Rays, CT scans as well as CAT scans.

Treatment of spine using bone grafts

Instrumented Fusion and Osteotomy

When older children develop progressive kyphotic curves, surgery may be performed that includes the use of instrumentation such as screws, hooks, and rods, to help correct the condition. If the risk to the spinal cord it too high to consider manipulative techniques to correct the curve, the surgeon sometimes will remove the vertebrae that are misshapen in order to straighten the spine.

In some cases, surgeons recommend an osteotomy, which involves cutting the bones in order to re-align the spine. Sometimes the bone is removed from the back of the vertebrae to allow the bone to collapse backward. This procedure is called a pedicle subtraction osteotomy. In vertebral column resections, the back and the front of the vertebrae are resected through an incision made in the back. Surgeons sometimes recommend different procedures be performed from both the back and the front of the spine.

Taking care after a bone graft procedure

Many patients will experience pain, this is only natural after any surgical procedure. Recovery time after a bone graft for spinal fusion can vary one patient to another but children will naturally heal faster than adults and elderly patients. Often a back brace is worn to limit movement during the healing process and the patient will need assistance and care within their home.

The patient will be prescribed medication to follow after the bone graft procedure and will need to complete any antibiotics course prescribed. The patient cannot overexert themselves during healing time.

You might also want to read:
- Corpectomy,
- Discectomy.

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Questions & Answers
Q:
What is the best way to treat permanent back and neck pain and stiffness?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Use a telephone headset

Never hold a phone between your shoulder and your ear. Use a headset or other hands-free system to talk on the phone and avoid abusing your neck and spine.

Neck Pain Tips: Exercise your neck muscles

One of the best neck pain tips is using the chin tuck. You can do this often throughout the day. In addition to helping strengthen the muscles that hold the head in alignment over the shoulders, it also helps strengthen the scalene and sub-occipital muscles.

Read more tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

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Temed Holdings
4 answers
Q:
What is the best treatment for neck pain and shoulder Pain?
A:

One of the best treatment for neck pain and shoulder pain is exercises:

Neck Pain Exercises: Neck Extension

  1. To begin this neck pain exercise, sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the palm of your hand on the back of your neck, at the base of your head
  4. Apply slight forward pressure with your hand, while resisting the forward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax
  6. Repeat the neck pain exercises 5-10 times

Neck pain exercises: Side bend

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place your left hand, palm down, on the left side of your head (around your ear)
  4. Slightly push your head to the right side with your hand, while resisting the sideways motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat 5-10 times
  7. Repeat the neck pain exercises with the other side.

Neck pain exercises: Neck flexion

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the tips of your fingers on your forehead
  4. Slightly push your head backward with your fingers, while resisting the backward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat the neck pain exercises 5-10 times

More exercises here: Neck Pain Exercises

Read more
Temed Holdings
4 answers
Q:
How do I reduce the shoulder and neck pain?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Carry weight evenly

Many people make the mistake of carrying a heavy briefcase or their purse on their shoulder or on one side of their body. Doing this causes strain in the muscles and leads to pain.

Remove non-essentials from your briefcase or purse. Consider using a backpack to evenly distribute the weight across your shoulders. If you choose to carry a purse or backpack, keep your shoulders level while carrying it.

Neck Pain Tips: Maintain a proper posture

The most common posture contributing to neck pain is the “head-and-shoulders-forward” posture. In this position, the neck slopes forward, putting the head in front of the shoulders.

In this position, the head pulls the upper back forward also in a slumped position. This places a strain on the entire spinal column.

More tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

Read more
Temed Holdings
4 answers