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Controversies about spine fusion surgery
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While physicians agree on many things about spine fusion surgery, there are some
areas that lack consensus. Two such areas are the type of bone used (autograft vs.
allograft) and how many levels should be fused.
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Type of bone used with fusion surgery |
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Whether an autograft or allograft is used is based mostly on a combination of the
surgeon’s and patient’s preference. Some surgeons still feel most comfortable with
autograft as it yields the best fusion rates. Other surgeons have had good results
with allograft bone and wish to avoid the postoperative pain and possible complications
associated with harvesting a bone graft.
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In some instances, it may be more compelling to use a patient’s own bone. There
are some situations where it is more difficult to get a solid fusion and using a
better bone graft is reasonable. Factors that may make obtaining a solid fusion
difficult include: |
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Revision surgery (previously failed grafts) |
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Smokers/smokeless tobacco product users |
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Multiple level fusions
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Disease states which inhibit bone healing or which require medications that do so |
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