Anterior Cervical Discectomy and Fusion

The medical practice of anterior cervical discectomy and fusion, commonly referred to as ACDF, is a prevalent surgical procedure employed for the management of cervical spine disorders. This procedure is mainly used for the treatment of neck-related ailments resulting from a degenerated or herniated disc. Disc degeneration and herniation are typical conditions affecting the disc, which can cause compression of spinal nerves and the spinal cord housed in the spinal canal.

Neurologic structures that experience compression or pinching can cause a range of symptoms, including neck, shoulder, upper back, and arm pain. Patients may also experience neurological complications such as numbness, tingling, and weakness in the arms or hands. An ACDF procedure aims to alleviate these symptoms by decompressing the affected nerve roots and spinal cord, stabilizing the neck, and allowing patients to return to their normal daily routine.

Anterior = Front

The surgeon will make an incision in the front part of the neck (left or right side) either within a natural skin crease or skin fold for concealing incision once healed. It ensures attractive and desired cosmetic result.

Cervical = Neck

The cervical region is a distinct section of the spinal cord, comprising seven vertebral bodies in the neck, each numbered from C1 (topmost) to C7 (bottom). Additionally, the disc levels within this region are also abbreviated, for instance, C3-C4, referring to the intervertebral disc located between the third and fourth cervical vertebral bones.

Discectomy = to remove the disc

During the procedure, the surgeon creates an incision to access the affected region and gently shifts aside soft tissues to expose the disc. Thereafter, specialized instruments are employed to extract the damaged disc from between the upper and lower vertebral bodies.

Fusion = to Join or Combine

After removing the ruptured disc, a bone graft is inserted into the resulting gap between the upper and lower vertebral bodies. The neck will be stabilized by implanting a cervical plate and screws. The natural healing mechanisms of body come into play, leading to the growth of new bone tissue around and into the instrumentation, culminating in the successful fusion of the spinal region.

While not all patients with cervical degenerative disc problems or herniated discs require spine surgery, Neuro Spine & Pain Center's doctors may suggest an anterior cervical discectomy and fusion under specific circumstances. These may include a lack of response to non-operative treatment, deteriorating neurologic symptoms or pain, spinal instability, and/or neurological issues. Neurologic dysfunction, such as numbness, loss of function, and weakness, are some examples of these conditions.

Types Of Bone Graft

The following types of bone graft are recommended for patients:

  • Autograft – It involves taking patient’s own bone from the hip.
  • Allograft – It is donor bone from a bone bank.
  • Bone graft substitute – These are of different types, some of these are synthetic (man-made) and available in varied shapes.

Screws are attached to a metal plate over the bone graft. This plate helps hold the graft in place and stabilizes the neck. Fluoroscopy is usually used during ACDF. A post-operative x-ray is taken to ensure the bone graft and instrumentation is well-positioned.

Risks or Complications of Anterior Cervical Discectomy and Fusion

Along with anesthetic complications, spinal surgery involves several potential risks, such as blood clots, infections, blood loss, bowel and bladder complications, and nerve damage. One critical complication of spinal fusion is the inability to fuse vertebral bones with the bone graft, which often necessitates additional surgery.

Is ACDF Surgery Painful?

ACDF is a type of minimally invasive surgical procedure. It involves dissection of less soft tissue. Following ACDF surgery, patients may experience a sore throat or hoarse voice, which typically resolves quickly after the surgery. Patients may also encounter temporary discomfort while swallowing. However, in rare cases, some patients may also experience other side effects such as dysphagia, a condition characterized by difficulty in swallowing, which can be managed effectively.

How Long Does It Take To Recover From ACDF Surgery?

Following the ACDF Surgery procedure, patients are normally required to stay in the hospital for at least one night. Some may be allowed to leave on the same day while others may need to remain hospitalized for a couple of days longer. Full recovery from the procedure usually takes between 4-6 weeks, during which patients have to adhere to specific activity restrictions. These limitations include refraining from driving, bending, lifting, pushing, pulling, or reaching. Moreover, in most cases, sexual activity is also prohibited.

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