Background Information:

What are the other Names for the Procedure?

• Bone Spur Surgery
• Excision of Bone Spur
• Removal of Bone Spur

What is Bone Spur Removal surgical procedure?

• A bone spur is a protrusion on the surface of the bone, due to abnormal growth of the bone. Bone spurs may develop on any bone. They most commonly occur on the feet, elbow, and spine
• Sometimes, this can cause severe pain that do not respond to conservative treatments. In such cases, a surgery may be performed to remove the bone spur. This is known as a Bone Spur Removal surgical procedure

What part of the Body does the Procedure involve?

A Bone Spur Removal surgical procedure involves:

• The affected bone
• Ligaments that are attached to the bone
• Any joint near the affected bone (in rare cases)

Why is the Bone Spur Removal surgical procedure Performed?

A Bone Spur Removal surgical procedure may be performed for the following reasons:

• Often, bone spurs are painless; though sometimes, they can be associated with intermittent and chronic pain, if inflammation develops at the point of spur formation
• Depending on the location of the bone spur, the pain may worsen while walking, jogging, or running
• In most cases, a surgery is successful in treating the condition and relieving pain

What are some Alternative Choices for the Procedure?

• Bone Spur Removal surgery is generally used only as a last resort, after conservative treatment methods have failed to produce successful results
• When a bone spur is identified and treated early, conservative methods usually prove to be effective in many cases; particularly, in cases with mild to moderate pain
• However, if left unchecked, bone spurs and their associated symptoms may become more serious, in which case a Bone Spur Removal surgical procedures may be required

The conservative treatment measures for bone spurs include:

• Stretching exercises
• Shoe-related recommendations, such as shoe inserts or orthotic devices (if a bone spur has developed in the heel)
• Taping or strapping to rest stressed muscles and tendons
• Physical therapy
• Over-the-counter medications, such as acetaminophen, or anti-inflammatory medications, such as ibuprofen, to help relieve pain
• In some individuals, steroid injections may be used to relieve inflammation

What are the Recent Advances in the Procedure?

• If a bone spur has developed on the heel, endoscopic plantar fasciotomy is a recent advancement to remove the bone spur
• Overall, however, there are currently no alternatives available to a Bone Spur Removal surgery

What is the Cost of performing the Bone Spur Removal surgical procedure?

The cost of Bone Spur Removal surgical procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused by the information regarding Removal of Bone Spur procedure and on what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
• Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.fairview.org/healthlibrary/Article/84857 (accessed on 2/17/2017)

http://www.ohsu.edu/xd/health/services/ortho/getting-treatment/minimal-incision-toe-bone.cfm (accessed on 2/17/2017)

Prior to Bone Spur Removal surgical procedure:

How is the Bone Spur Removal surgical procedure Performed?

• After a healthcare provider administers a local anesthetic to numb the area, an incision is made over the area of the spur
• Guided by a small camera, small instruments are used to completely remove the excessive bony growth
• The bone surface from which the spur is removed is then evened (levelled) out
• The removed bone is sent to a pathologist for examination
• The skin incision is sutured and closed (if necessary)
• Removal of the bone spur can diminish pain to a great extent, since it prevents the tissue around the affected area from being damaged further by the bone fragment

Regardless of the procedure adopted, it is advisable to obtain more information from the orthopedic surgeon. This can help learn about each individual procedure that is available for the condition, and make a choice that is most suited or appropriate.

Where is the Procedure Performed?

The Bone Spur Removal surgery is usually performed in an out-patient surgery center facility. Normally, the individual can go home, once the procedure is completed.

Who Performs the Procedure?

The Bone Spur Removal surgical procedure is performed by an orthopedic surgeon and assisted by an anesthesiologist.

How long will the Procedure take?

It usually takes anywhere between 1-3 hours, to complete the Bone Spur Removal surgical procedure.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to the healthcare provider. This enables the healthcare provider in assessing the risks for the Bone Spur Removal surgical procedure and helps avoid unnecessary complications.

• Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
• If you are allergic to any specific medication or food items
• If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
• If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
• If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
• If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
• If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
• A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
• Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
• Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
• Normally local anesthesia is not used in Bone Spur Removal procedure; however, do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
• Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
• It is advisable to quit smoking and the use of any nicotine based products for a while, before the surgery
• Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
• The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
• For individuals suffering from diabetes, it is important that the blood sugar stays within the normal range; if not, their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines

What is the Consent Process before the Procedure?

A physician will request your consent for Bone Spur Removal procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Bone Spur Removal surgical procedure?

• An X-ray of the affected area will indicate the bone spur protrusion
• If the bone spur is near a joint, then a MRI scan of the region may be needed

The healthcare provider may suggest further tests depending on the condition of the individual and their medical history.

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

• What is a Bone Spur Removal surgical procedure?
• Why is this procedure necessary? How will it help?
• What does the procedure involve?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• What are the risks while performing the procedure?
• What are the possible complications that might take place during recovery?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• What are the costs involved? 

During the Bone Spur Removal surgical procedure:

What kind of Anesthesia is given, during the Procedure?

General anesthesia is administered during a Bone Spur Removal surgical procedure.

How much Blood will you lose, during the Procedure?

• Since the Bone Spur Removal surgical procedure requires only a small incision, the amount of blood loss is minimal
• If complications arise during the procedure, it could lead to a further loss of blood

What are the possible Risks and Complications during the Bone Spur Removal surgical procedure?

There are general factors that increase the risk of getting complications during the surgical procedure and they include:

• Obesity: Generally, the greater the degree of obesity, the greater the surgical risk
• Smoking: The longer the smoking history (in pack years smoked), the greater the surgical risk
• Advancing age
• Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
• Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
• Poorly functioning liver, as evidenced by increased blood liver function tests
• Hypertension (increased blood pressure), especially if it is poorly controlled
• Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
• Poor lung function, as evidenced by abnormal lung function tests
• History of bleeding disorders
• Longstanding illness, such as autoimmune disorders and chronic infections
• Poor immune system due to a variety of causes

The possible risks or complications that may arise during the Bone Spur Removal surgical procedure include:

• Bleeding
• Injury to the neighboring structures
• Anesthetic complications
• Need for further procedures

What Post-Operative Care is needed at the Healthcare Facility after the Bone Spur Removal surgical procedure?

At the healthcare facility, generally there is no requirement for any post-procedure care, unless any complications arise.

After the Bone Spur Removal surgical procedure:

What are the possible Risks and Complications after the Bone Spur Removal surgical procedure?

Post Bone Spur Removal surgical procedure, the following complications may arise:

• Infection of the surgical site
• Bleeding from the surgical wound
• Pain and discomfort
• Permanent numbness due to damage to surrounding nerve

What is the Prognosis after the Surgery?

A Bone Spur Removal surgical procedure is successful in treating pain in most cases. The prognosis after surgery is generally good.

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms after the Bone Spur Removal surgical procedure:

• Pain around the surgical wound
• Swelling and redness
• Bleeding or fluid drainage around the region of surgery
• Fever
• Dizziness
• Signs of infection

What Post-Operative Care is needed at Home after Bone Spur Removal surgical procedure?

At home, the following post-operative care is recommended, after a Bone Spur Removal surgical procedure:

• At the end of the surgical procedure, the wound is covered and a short plaster splint applied. This dressing and splint gives support to the affected area, holding it securely. The dressing should be left intact, until seen by the surgeon (on subsequent visits)
• If a bone spur developed in the heel, do not walk on the splint; bearing weight on the affected foot, will delay the tissue healing in that area. In some cases, it may be necessary for individuals to use bandages, casts, surgical shoes, crutches, or canes, for some period, after the surgery
• If the splint gets wet or there is a problem with it, please inform the healthcare professional immediately

How long does it normally take to fully recover, from the Procedure?

It may take anywhere between 6 weeks to 3 months, to fully recover from the Bone Spur Removal surgical procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The bone spur tissue is taken for further examination and later disposed, as per the standard medical procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

• The bone spur tissue removed is processed in the laboratory under a pathologist's supervision
• Slide(s) are prepared once the tissue is processed and this is examined by a pathologist and a pathology report issued
• Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time

Who will you receive a Bill from, after the Bone Spur Removal surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from: 

• The outpatient facility
• An anesthesiologist
• The operating surgeon
• A pathologist

The patient is advised to inquire and confirm the type of billing, before the Bone Spur Removal Surgery is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA