I need a lumbar spinal fusion, can I use bone from my brother instead of my own?
Answers:
Lots of information going on here - so I'll be brief. I just celebrated the one year anniversary of a double fusion of L4/L5 and L5/S1.
I've heard that using your own bone is tremendously painful...worse than the actual surgical site. For my fusion, they used cadaver bone. I know...I know...that sounds almost too horrible for words. I'm glad I didn't know about it until after I woke up. However, this saved a tremendous amount of pain and suffering on my part - which was pretty extensive on it's own. And the person that donated the bone had given me a wonderful gift. Through their generosity, I can live life at a much reduced pain level.
Good luck with your surgery. I'm betting you'll do great. Just educate yourself fully and have realistic expectations. Most of all, surround yourself with friends and family, and don't push yourself. In time, things get much easier.
If the tissue matches, sure. Good luck.
No surgeon is going to put your brother through the risk of surgery unnecessarily. The amount of bone used for the fusion is pretty small. Sometimes they use bone they get out of your spine during the surgery, and other times they take it out of your hip bone.
Your own tissue is ALWAYS better than someone else's. No chance of a reaction.
Sometimes cadaver bone is used. Ask your surgeon about that if you don't want them to harvest from your hip.
Lumbar spinal fusion surgery
A spinal fusion surgery is designed to stop the motion at a painful vertebral segment, which in turn should decrease pain generated from the joint. All lumbar spinal fusion surgery involves adding bone graft to an area of the spine to set up a biological response that causes the bone graft to grow between the two vertebral elements and thereby stop the motion at that segment.
For patients with the following conditions, abnormal and excessive motion at a vertebral segment may result in pain:
Degenerative disc disease
Isthmic, degenerative or postlaminectomy spondylolisthesis.
Other conditions that may be treated by a spinal fusion surgery include a weak or unstable spine (caused by infections or tumors), fractures, scoliosis or deformity.
How spine fusion surgery works
At each level in the spine, there is a disc space in the front and paired facet joints in the back. Working together, these structures define a motion segment and permit multiple degrees of motion. Two vertebral segments need to be fused together to stop the motion at one segment, so that an L4-L5 (lumbar segment 4 and lumbar segment 5) spinal fusion is actually a one-level spinal fusion.
A spine fusion surgery involves using bone graft to cause two vertebral bodies to grow together into one long bone. Bone graft can be taken from the patient's hip (autograft bone) during the spine fusion surgery, or harvested from cadaver bone (allograft bone). Synthetic bone graft substitutes are also in development, and one type - bone morphogenic proteins (which helps the body create bone)—is currently being used for certain fusion procedures.
In general, a lumbar spinal fusion surgery is most effective for those conditions involving only one vertebral segment. Most patients will not notice any limitation in motion after a one-level spine fusion. Only in rare cases should a three (or more) level fusion surgery for pain alone be considered, although it may be necessary in cases of scoliosis and lumbar deformity.
When necessary, fusing two segments of the spine may be a reasonable option for treatment of pain. However, spinal fusion of more than two segments is unlikely to provide pain relief because it removes too much of the normal motion in the lower back and places too much stress across the remaining joints.
There are several types of spinal fusion surgery options, including:
Posterolateral gutter fusion—the procedure is done through the back
Posterior lumbar interbody fusion (PLIF)—the procedure is done from the back and includes removing the disc between two vertebrae and inserting bone into the space created between the two vertebral bodies
Anterior lumbar interbody fusion (ALIF)—the procedure is done from the front and includes removing the disc between two vertebrae and inserting bone into the space created between the two vertebral bodies
Anterior/posterior spinal fusion—the procedure is done from the front and the back
It is important to note that with any type of spine fusion surgery, there is a risk of clinical failure (meaning that the patient's pain does not go away) despite achieving a successful fusion.
There is no evidence of whether a patient should use their siblings bone. Sorry, but why put your brother through such a terrible ordeal, unless it was your only option?! Good luck and hope all goes well for you (and your family).
Why on earth would you ask your brother to do this? You are already going to have the surgical procedure, and general anesthesia. Any time there is general anesthesia, there is risk, why double it? Unless there is some condition I cannot imagine for you doctor to think your own bone would not be better, I would definitely recommend sticking with your own.
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