Ten years ago, I had a cervical spine fusion using bone from a bone bank. Never again! I had the worst results with infection, bone rejection, and eventual breakdown of the fusion. Now I have to go in and have it done over again along with a fusion of the level above. I keep hearing horror stories about donating bone to myself but it couldn't be worse than what I've already been through. What do you think?
There are several things to consider here. First, allografts (donor bone from a bone bank) have had some problems in the past. But with new techniology, improved sterilization, and the ability to reduce viruses and bacteria, allografts are chosen by surgeons more often than autografts.
Autografts use bone harvested from the patient -- usually from the pelvic bone. There is less risk of donor rejection but many times the donor site is more painful and problematic than the surgical site. The patient can end up with more days of pain and misery from the autograft bone harvest than if an allograft had been used.
In fact, studies show that more than half of all patients who have bone harvested from the pelvic bone have difficulty walking. Chronic pain in the donor site area is present in one-fourth of all patients. Half of these patients end up taking pain medication on a long-term basis.
Then there's the cosmetic appearance of the donor site. Many patients think the scarring won't bother them but the results can be unacceptable after the fact. And finally, harvesting bone from the patient adds time in the operating room and under the effects of anesthesia.
With the improved safety and effectiveness of allografts, you may want to rethink your decision. The best one to advise you is your surgeon. He or she can give you all the pros and cons from his or her experience as well as take into consideration any personal factors that are unique to you.
Larry E. Miller, PhD, and Jon E. Block, PhD. Safety and Effectiveness of Bone Allografts in Anterior Cervical Discectomy and Fusion Surgery. In Spine. November 15, 2011. Vol. 36. No. 24. Pp. 2045-2050.
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