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I went with my husband to the surgeon who is going to do a spinal fusion on him. They are going to use bone from along the back of his pelvic bone for the graft. We had to sign a lot of papers telling us over and over that the donor site could cause problems. Is this really such a big problem? Should we find a different surgeon?

Over the years, there have been many reports of pain after surgery at the donor site. In fact, many patients complain more about problems at the donor site than at the primary site of the surgery. The incidence of this problem is reported anywhere from six to 39 percent in various studies.

A recent study from two orthopedic surgeons in The Netherlands may offer some new insight into this problem. They compared patients having a spinal fusion at the T2 to L2 levels with patients having the same surgery at L3 or below. All the patients had a traumatic fracture of the spine requiring a fusion.

They found that 40.9 per cent of the patients who had the low fusion reported chronic donor site pain. This is almost half of the entire group. Only 14 per cent of the patients with a high level fusion had similar problems.

It looks like the site of the low fusion is close enough to the donor site that the patients can't tell the difference. This fact may result in an overestimate of true donor site pain.

Patients are warned about the donor site pain for two reasons. It's natural to think the operation is going to take care of the painful back symptoms. Patients aren't expecting to have more pain after surgery. And from all reports, it looks like donor site pain is often much worse than the painful back disorder.

Surprises like this are not appreciated by most people. Surgeons may find that the information presented up front is a good way to avoid a dissatisfied patient.

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