My surgeon carefully went over each step of the spinal fusion procedure I am going to have next week. I will have bone from a bone bank grafted in to help with the fusion. I have osteoporosis myself and can't donate my own bone. I did hear something about the risk of infection but the information was all so new and flew right past me. Is the infection from the bone graft because it's donated bone or does it develop from something else?

The two basic bone grafts used in spinal fusion are either autografts (harvested from the patient) or allografts (obtained from a donor bank). Each type of grafting material has its own advantages and disadvantages. But apparently, infection based on bone graft type isn't one of them.

Bone used from a bone bank comes from donors who have been screened very carefully. The tissue may be irradiated to reduce the risk of transmitting any diseases or infections from the donor to the recipient. Bone banks have strict procedures that also involve quarantine of the donated tissue for a certain length of time to watch for any potential problems. Surgeons are careful to use bone banks with an excellent track record for preparation of donor bone with minimal risks and rates of infection.

According to a recent study from the Mayo Clinic in Rochester, Minnesota there is no difference in postoperative infection rates based on type of bone graft used. That means the surgeon can choose the type of bone graft based on the patient's needs, availability of autograft versus allograft, and what's needed for the particular surgical procedure planned. Patients were followed for at least one full year after surgery. The overall infection rate for all three types of grafts was only five per cent. Most of the infections that did occur developed within the first 60 days.

Post-operative infection in the early days, weeks, and months after spinal fusion is a major concern. That's because it isn't just an isolated problem. With it can come osteomyelitis (infection enters the bone), failure of getting a solid fusion, and pseudoarthrosis (movement at the fusion site). Potential risk factors for infection include patient age (older than 60 years old), tobacco use, diabetes, obesity, and alcohol abuse. Length of surgery and surgical technique can also add to the risk of infection postoperatively.

Mark M. Mikhael, MD, et al. Postoperative Culture Positive Surgical Site Infections After the Use of Irradiated Allograft, Nonirradiated Allograft, or Autograft for Spinal Fusion. In Spine. October 15, 2009. Vol. 34. No. 22. Pp. 2466-2468.

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