Bone Spur Surgery

What is Bone Spur Surgery?

Bone spur surgery is a surgical procedure to remove a bone spur. Also known as osteophytes, bone spurs are bony growths that develop often where two bones meet in a joint. Bone spurs can cause symptoms such as pain and restricted movement. 

Surgical removal of bone spurs is an option when non-surgical approaches fail to improve symptoms. Your orthopedic doctor will evaluate the severity of your spurs. Before recommending bone spur surgery, the doctor will consider factors such as overall health, lifestyle, size and location of bone spurs, degree of pain and impairment, and the impact on nearby structures.

Although there are different approaches to bone spur surgery (see below), they involve the same principle – the surgeon makes a cut in the skin and soft tissue below to access the bone spur and remove it. During bone spur surgery, the surgeon may use general or local anesthesia depending on the location and size of the spur(s). 

The duration of the procedure depends on the complexity and number of bone spurs and may range anywhere from 30 minutes to two hours. Since bone spur surgeries are performed on an outpatient basis, you are likely to go home the same day. Your surgeon will explain the course of the procedure and gives instructions regarding the recovery process.

Types of Spur Removal Surgery

Bone spurs can develop in any joints. For example, these bony growths may form on the bottom of the heel, outside of the foot, on top of the foot, between toes, and on other parts of the body including the shoulders, hips, and spine. 

Bone spurs cause the most severe symptoms in weight-bearing or high activity joints such as the hips, spine, knees, shoulders, and feet, especially heels.  

Your orthopedic surgeon will choose the surgical approach that best suits your specific needs and the severity of the condition. 

Open surgery is the traditional approach during which the surgeon makes an incision in the skin over the affected area to access the bone spur. Then, they remove the piece of bone. Surgeons typically choose open surgery to manage larger, deep-seated bone spurs. 

Minimally invasive surgery may include arthroscopic surgery. These procedures rely on arthroscopes, tools with flexible cameras that help surgeons visualize and treat bone spurs. A minimally invasive approach involves smaller incisions, and has lower risk of scarring, as well as may have a faster recovery compared to an open procedure. 

The general steps of a minimally invasive (arthroscopic) bone spur surgery are as follows:

1. Make small cuts (incisions) around the joint.
2. Insert arthroscope (camera) through one of the incisions. 
3. Examine the joint and identify bone spurs.
4. Insert arthroscopic instruments through other small incisions.
5. Use a shaver or burr to smooth out the affected surface, removing the bone spurs.
6. Inspect the joint to make sure all bone spurs or damaged tissues are removed.
7. Close incisions.

The steps for an open surgery are similar, but involve larger and fewer incisions (usually just one) and do not involve the use of a camera. 

Shoulder Bone

Your doctor may recommend shoulder bone spur surgery when conservative treatments such as physical therapy, injections, and medications fail to relieve the pain. You may also need surgery if the bone spur causes significant movement restriction. 

Surgical options for shoulder bone spurs include open and minimally invasive, or arthroscopic, operations. Open surgery is typically only considered for severe cases, as  minimally invasive procedures involve smaller incisions and have a faster recovery period. In order to perform this procedure, the surgeon will:

Shoulder acromioplasty and debridement are two types of shoulder bone spur surgeries and are similar procedures. Both are minimally invasive, but their target isn’t entirely the same. Acromioplasty focuses on the acromion (top outer edge of the shoulder blade) primarily whereas debridement is a procedure that focuses on the broader shoulder joint area. The procedure type depends on the location of your shoulder bone spur. 

Achilles Tendon

Achilles bone spur surgery is a treatment for severe Achilles tendinopathy, or inflammation of the tendon, secondary to spur formation. The injury primarily affects runners who have suddenly elevated the intensity of their pace, but since it’s an overuse injury, anyone can develop it.

The first-line approaches for Achilles tendinopathy include physical therapy, corticosteroid injections, anti-inflammatory medications, and accommodative footwear.

Surgery is necessary only in instances when the non-operative measures are ineffective. The surgical procedure targets the bone at the back of the heel.

Minimally invasive Achilles bone spur surgery and open surgery have the same premise, though minimally invasive involves use of an arthroscope (camera). The main goal of the Achilles tendon bone spur surgery is to remove damaged tissue or bone spur. In order to perform this operation, your surgeon will:

1. Make a cut along the Achilles tendon
2. Identify and remove the bone spur and smooth the surface of the heel bone
3. Clean and repair any damaged or degenerated parts of the Achilles tendon
4. Repair healthy tissue and reattach the Achilles tendon with strong anchors 
5. Close the incision.

Heel Spur Surgery

Like in other cases, heel spur, or calcaneal spur, surgery is considered refractory or treatment-resistant pain. 

Heel spur removal can be performed as open or minimally invasive surgery. Your surgeon will recommend the best approach based on the size of the heel spur and the severity of symptoms. Two common approaches are inferior heel spur resection and posterior heel spur resection based on the location of your spurs.

In order to perform the calcaneal spur surgery, the doctor needs to:

1. Make a cut on the back of the heel to gain access to the heel bone
2. Detach the Achilles tendon to remove the heel spur (detaching the tendon depends on the severity of the spur)
3. Remove the heel spur by shaving or cutting away the bony growth
4. Reattach the tendon if it’s been removed 
5. Ensure the resection is smooth to prevent the remaining bone from causing irritation 
6. Wash out the surgical area to remove bony fragments 
7. Close the incisions. 

Top of the Foot

Surgery for a bone spur on the top of the foot is necessary when conservative treatment is unsuccessful. This can also be performed with a minimally invasive (arthroscopic) or an open approach. The bone spur on top of foot surgery involves the following steps:

1. Make a cut over the area where the bone spur is located
2. Identify the bone spur
3. Remove the bone spur with specialized instruments
4. Close the incision.

Spinal

The advantages of spinal bone spur surgery include pain relief, improved mobility, and better quality of life. 

The procedure to remove spinal bone spurs is called a laminectomy, which can be used to remove bone spurs and create space in the spinal cord if the cord is being compressed. The surgery involves the following steps:

• The surgeon makes one incision for open surgery or several smaller incisions for minimally invasive operation in the back over the affected vertebrae 
• Small instruments are used to remove the bone spurs and the smallest amount of lamina (back part of each vertebra) to create more space and gain better access to bone spur
• The bone spur is removed.
• The incision is closed and a sterile dressing is applied.

Hip

Similar to other types of bone spur surgery, hip bone spur surgery can be performed if physical therapy and medical management do not relieve hip pain. Hip arthroscopy is a surgery to remove bone spurs that form on the femoral head, the highest part of the thigh bone. 

Recovery from Bone Spur Surgery

Since bone spur surgery is performed as an outpatient procedure, you can usually expect to go home the same day. You should plan to have a ride set up, as you will not be able to drive for at least 1 day after anesthesia. Recovery after a bone spur surgery is a vital part of the healing process.

The exact duration of the recovery period depends on factors such as the size and location of the bone spur, the surgical approach (open vs. minimally invasive), and your overall health.

Full bone spur removal surgery recovery time and return to normal activity can last anywhere from 10 days to a few months.

Pain After Bone Spur Surgery

You may need to take medications to manage pain and use ice packs to reduce swelling. 

• Over-the-counter pain medications that can help are acetaminophen (Tylenol) and ibuprofen (Advil). These medicines can be alternated every 4-6 hours for maximal pain control. 
• You may also be prescribed a short course of prescription pain medications for the first few days. 
• Try to ice your wounds for 10-20 minutes at a time every 1-2 hours in the first few days after your surgery. This will help minimize swelling and give pain relief. 
• If your doctor prescribed you antibiotics, make sure to take the full course. You should not stop when you feel “better”. 

Wound Care

You will be instructed to keep the surgical site clean and dry with your post-operative bandage intact for 24-48 hours. 

• Follow the instructions given by your surgeon for when to remove the bandage. 
• If your surgeon put strips of tape (Steri-strips) across your incisions, leave these in place until they naturally fall off. If there are loose ends, you can trim these with scissors, but do not pull the tape off. 
• During weeks 2-4, you will need to attend a follow-up appointment with the surgeon. The surgeon will assess the surgical site and remove the sutures or staples if necessary.
• Your surgical site(s) may look red, bruised, and/or swollen after your procedure. This is normal. If you notice that the redness is spreading instead of shrinking or the skin becomes warm to the touch or starts draining thick or foul-smelling fluid, you should contact your surgeon’s office immediately. 

Activity & Lifestyle

You may begin with gentle movements as advised by your doctor, but make sure to avoid strenuous activities and heavy lifting. Driving isn’t advised until you can safely and comfortably operate your vehicle, which is why you may need to wait for a few days.

Depending on where in the body your bone spur surgery took place, you may need to use crutches, a brace, or a sling. Follow your surgeon’s instructions for how to use these. 

You may need to start with physical therapy to improve strength, range of motion, and flexibility. Gradually increase activity levels as tolerated. 

The incision should be healed by the weeks 4-6. You may need to continue with physical therapy exercises. At this point, most patients return to daily activities, though more strenuous activities/exercise will depend on the location of the bone spurs and your progress. Discuss return to exercise with your surgeon prior to starting.

A great deal of the bone spur surgery recovery process and its timeline depends on you as a patient. For that reason, it is crucial to adhere to the doctor’s instructions regarding activities to avoid or exercises to do.

NOTE: the exact timeline of the recovery process depends on several factors including the type of surgery (open or minimally invasive).

Recovering from Shoulder Spur Surgery

Bone spurs in shoulder surgery recovery time depends on the type of surgery you had. You may feel better in a few days to a few weeks. Specific considerations that affect the surgery recovery process for shoulder spurs include the use of slings, which are crucial in the early stages after the surgical procedure to immobilize the shoulder and support the healing process. You will need to wear a sling for at least one week or up to six weeks, depending on the type of procedure you had. 

The passive use of the arm can start within the first week and gradually progress to active use within four to six weeks. The full return to sports depends on your recovery, but it can take four to six months. You may expect to start driving around 6 to 12 weeks after the surgery. 

Recovery in Heel Spur Surgery

Although heel spur surgery recovery time of a few weeks is achievable, sometimes it may take up to three months to make the full recovery after this procedure. You can expect to wear a bandage over the incision for about two weeks. You may need to use crutches when walking or participating in other weight-bearing activities. 

Physical therapy plays a major role in the recovery process. You may need to perform gentle exercises to increase your range of motion and prevent stiffness. Gradually, you will progress to functional activities and strength-building exercises. You may transition from crutches to weight-bearing as tolerated within 4-6 weeks. Resuming sports activities depends on how well recovery is going, but it can take 3-4 months.

Driving considerations depend on the foot that was operated on and the type of vehicle you own. For procedures on the left foot, you can return to driving the day after the surgery if you are driving an automatic car because this foot isn’t necessary for pedal operation. On the other hand, driving may be delayed for a few weeks if you’re driving manual transmission cars. 

For surgeries on the right foot, it may take a while to return to driving. You may need to wait for several weeks until your right foot is well and you’re able to safely and comfortably the accelerator and brake pedals regardless of the vehicle you’re driving.

Recovery in Neck or Spine Spur Surgery

The recovery for bone spurs in the neck or spine depends on the specific procedure you undergo. You should avoid heavy lifting, bending, twisting, or making sudden movements that could jeopardize the surgical site. Moreover, you should avoid prolonged periods of sitting or working at a computer without breaks as these activities could increase tension in the neck area. Make sure to maintain proper posture.

Risks of Bone Spur Surgery

Bone spur surgery is generally safe with risks that are typical to any surgical procedures. These include:

• Infection
• Bleeding
• Nerve damage
• Blood clots
• Adverse reactions to anesthesia 

Side effects that may occur include:

• Pain and swelling
• Fatigue
• Decreased range of motion
• Bruising
• Skin discoloration
• Chronic pain

Is Bone Spur Surgery Painful?

Pain after bone spur surgery depends on the type of procedure. Minimally invasive surgeries typically involve less pain than open surgery.

Dr. Mehta may suggest taking medications for pain relief, as listed above, and will provide clear postoperative and care instructions to ensure the recovery process is as smooth as possible.

Moreover, Dr. Mehta calls regularly to check up on you.

Is Bone Spur Surgery Dangerous?

Bone spur surgery involves risks such as infection, nerve damage, chronic pain, continuation of symptoms, or decreased range of motion. However, the procedure is safe. This is particularly the case with minimally invasive operations. Studies show that bone spur surgeries have a success rate of around 95%, which is outstanding.

Evidence confirms that procedures such as heel spur removal are safe with minimum complications. The answer to whether bone spur surgery is dangerous is no; the complication risk is very low.