Spinal fusion is one of the most common surgeries done on the neck or back. The basic idea is to fuse together painful bones in the spine so that they heal into a single, solid bone. In order for bones to fuse or heal together, additional bone is needed. This additional bone is called a bone graft.
Many bone graft options are used today. They are often combined together. One popular method involves bone grafting, where the surgeon may utilize autograft bone, sourced directly from the patient’s own body, often from the pelvis.
Alternatively, allograft bone, which is bone harvested from a donor, can also be used. In some cases, a bone graft substitute might be deemed suitable. These substitutes often incorporate stem cells to promote bone growth and healing. The graft that is best for your problem will depend upon which section of your spine needs to be fused, your age, and your general health (AAOS, 2015).
There are a number of considerations to evaluate when deciding which type of bone graft options to use. The main factors to be taken into account include:
To date, using the patient’s own bone is considered the gold standard. However, this is not the best option for all patients.
In an effort to reduce the surgical risks and possible complications with using the patient’s own bone, and to enhance rates of fusion, the spine medicine community is focusing resources on developing better options.
When a spinal fusion is to be performed in an attempt to restore stability of the spine, one needs to achieve a solid biological union between at least two vertebrae. Typically, in order for this to occur, bone material is placed adjacent to the vertebrae to be fused. This bone material is referred to as “bone graft.” Traditionally, this bone graft material is harvested from a separate incision through the iliac crest (superficial part of the pelvis).
Currently, there are many alternatives to using one’s own iliac crest bone as bone graft material.
The surgical implantation procedure is performed through an incision in the abdomen (similar to an anterior lumbar interbody fusion).
With this approach, the organs and blood vessels must be moved to the side. This allows your surgeon to access the spine without moving the nerves.
Usually, a vascular surgeon assists the orthopaedic surgeon with opening and exposing the disc space. Most surgeries take about 2 to 3 hours.
Disc Design
The disc replacement device may comprise the nucleus (center) of the disc while leaving the annulus (outer ring) in place, although this technology is still in an investigative stage.
In most cases, total artificial disc replacements substitute the annulus and nucleus with a mechanical device that will simulate spinal function.
There are a number of different disc designs. Each is unique in its own way, but all maintain a similar goal: to reproduce the size and function of a normal intervertebral disc.
Some of the discs are made of metal, while others are a combination metal and plastic, similar to joint replacements in the knee and hip. Materials used include medical grade plastic (polyethylene) and medical grade cobalt chromium or titanium alloy.
Meet
Dr Hamid Mir is a board certified orthopedic spine surgeon with fellowship training in combined neurosurgery and orthopedic spine surgery. He has offices in OC, Los Angeles & Riverside. Dr Mir specializes in spinal fusion, lumbar surgery and treating trauma as well as other conditions affecting the lumbar, thoracic, and cervical spine including degenerative diseases, stenosis, fracture, infection, adult scoliosis, revision, and complex reconstructions.
Testimonials
I was in a very bad situation with a herniated disc in my lower back so I made an appointment with DISC spine center and Dr. Hamid. He was very professional and made me comfortable that he understood exactly what I was going through and was able to communicate effectively exactly what it will take to get me on the road to recovery after spine surgery. It took several months as my injury was severe however I always felt I was in good hands under Dr. Hamid’s supervision…If you ever have the misfortune of injuring your circuit board of your body (spine) you need a pro, do not take advice from anyone who’s not specifically licensed to help, Dr Hamid is who I chose and I’m very thankful.
Dr. Mir saw me about 2 months before the spine procedure and indicated that I had severe stenosis or narrowing of the openings where the nerve roots exit at the L4, L5 and S1 level. He reviewed my MRI and without wasting any time, asked if I wanted or was considering spinal surgery. He was extremely clear and answered all my questions. I had the procedure done at the Disc Newport OP surgery spine center and was cared for by an incredibly competent, caring staff. I was discharged same day and my post op recovery was 2 weeks, and returned to daily activities and work July 15th. The procedure was very successful as my back pain is basically gone. Amazing relief from a procedure done by a great surgeon with a great team!
Dr Mir is an excellent spine surgeon. I had a surgery on my neck by another surgeon but I was still in pain. A friend who had prior spine surgery with Dr. Mir recommended him to me. As the treating surgeon he was very detail oriented, confident, and knowledgeable. His team is very friendly and helpful. I decided to have a second cervical spine operation on my neck. Soooo thankful I have no pain and for physical medicine doctors like him.
Dr. Mir and his entire team of specialists take the extra time and consideration to shape alternatives to meet the needs (holistically) of the patient. Everything about the experience of my surgery was positive. Dr. Mir is a patient and compassionate surgeon. His communication skills are remarkably attentive. We are six months out of the starting gate from surgical treatment, and with PT and core strengthening exercises, this 65 yr. old is back to regular training for next year’s marathon. Thank you kindly El Doc-tor….you are amazing! See you soon.
Dr. Hamid Mir is a member of American Board of Orthopedic Surgery with fellowship training in combined neurosurgical and orthopedic spine surgery at Cedars Sinai Medical Center in 2004. As a top rated spine surgeon, he specializes in cervical, thoracic, and lumbar spine diseases including degenerative, stenosis, fracture, infection, scoliosis, revision, and complex reconstructions.
Dr. Mir focused his practice on minimally invasive techniques. As Medical Director of DISC Sports & Spine Center, Dr. Mir is at the forefront of the field of minimally invasive spine surgery. The benefits of these techniques include less post-operative pain, quicker recovery reduced blood loss, less soft tissue damage, smaller surgical incisions, less scarring and improved function.
ORANGE COUNTY LOCATION
3501 Jamboree Road Suite. 1250
Newport Beach, CA 92660