Anterior Cervical Discectomy and Fusion

Anterior cervical discectomy and fusion (ACDF) is a minimally invasive surgical procedure that relieves symptoms caused by bulging, degenerative discs and/or mal-alignment of the vertebra in the neck.

GOALS:

The goal of an anterior cervical discectomy and fusion is to relieve pressure on a nerve root in the neck by removal of damaged tissue, herniated disc and/or abnormal bone growth.

The practice of operating on the front side of the neck prevents disruption of the spinal cord, spinal nerves, and damage to the muscles in the back of the neck.

BENEFITS:

An anterior cervical discectomy and fusion can be both an outpatient or in hospital procedure with a 92-100% success rate in alleviating symptoms.

The post surgery recovery time is 4-6 weeks and the procedure has a low complication risk.

This creates a safer, less invasive procedure with a shorter recovery time.

ANATOMY:

A cervical disc, in the neck, absorbs impact and trauma.

Normal wear and tear of a cervical disc can result in disturbance of normal alignment of vertebrae and can result in abnormal bone growth or spurs.
This can cause foraminal cervical stenosis, or the narrowing of nerve root canals in the neck.

Encroachment on the nerve root by mal alignment, herniated discs or spurs may cause pain, numbness or muscle weakness in the hand and/or arm.

CONDITIONS TREATED:

Anterior cervical discectomy and fusion (ACDF) effectively treats pain numbness, and weakness in the neck, arm, and hand.
These symptoms are often caused by herniated or degenerative disc disease, Cervical stenosis, Cervical myelopathy or pressure on the spinal cord.

anterior cervical discectomy

PROCEDURE:

A small incision is made on the front, of the neck and under fluoroscopy the ruptured disc tissue is removed, relieving pressure on the nerve root and spinal cord and creating the space for the fusion.

In more severe cases, bone spurs are removed and nerve canals are enlarged (foraminotomy).

The space between the vertebrae is prepared to prepare for a healthy fusion with the bone graft, ensuring neck stability and decreasing the chance of further deterioration.

A metal plate is used to ensure good fusion alignment and the vertebrae fully fuse 3-6 months after surgery.

RISKS:

Some of the most common complications following Anterior cervical discectomy and fusion include:

  • Anesthesia risk
  • Intermittent difficulty swallowing, following surgery but this usually resolves over the first few weeks.
  • The nerve to the voice box can be injured during surgery with the nerve being stretched causing the patient to be hoarse for a few days or weeks after surgery. In rare cases if the nerve is actually cut, patients may have residual problems of hoarseness and voice fatigue.
  • Thrombophlebitis
  • Infection
  • Nerve damage
  • Problems with the graft- nonunion
  • Recurring pain

RECOVERY:

Most ACDF patients are discharged from the hospital the day after surgery, but your physician will determine the best postoperative course for you, depending on your recovery and any other health concerns.

Patients are able to return home when their medical condition is stable and to monitor their activities as the graft heals.

Your physician will discuss your pain medication requirement, wound care instructions, exercises, physical therapy, use of a collar and any activity restrictions, if applicable.