Anterior Cervical Discectomy Fusion
A surgical treatment to correct a cervical herniated disc by removing the affected disc through an anterior (through the front of the neck) approach. In most cases, fusion procedure is performed as well.
What is Anterior Cervical Discectomy Fusion?
- Resolves a variety of spinal conditions in the cervical (neck) area that have failed to relieve after attempting conservative treatments.
- Decompresses pinched spinal nerves and/or spinal cord. Removes herniated disc and bone spurs, and replaces disc with bone graft for vertebrae to fuse.
- Surgeons incise on the front of the neck, in the throat area.
- Procedure is microsurgery.
Anterior Cervical Discectomy Fusion (ACDF) is a procedure that alleviates the pressure put on one or more spinal nerves or spinal cord in the cervical (neck) area and stabilizes the vertebrae. This procedure is done through a small opening in the front neck area (anterior) between two vertebrae and replaces the affected disc with a bone graft to fuse the vertebrae together.
The cervical area of the spine supports the skull and runs through the neck area. If a spinal nerve in this area is affected, then pain and other debilitating symptoms may be experienced in the neck, shoulders, and upper extremities. Common symptoms may include pain, weakness, numbness, and loss of motor skills.
A variety of spinal conditions may cause complications that may compress against a spinal nerve. A herniated or bulging disc is common among patients requiring ACDF. Other conditions may include bone spurs, or spinal stenosis, which is a narrowing spinal canal. If non-operative treatments fail, then an ACDF may be recommended. The fusion of the vertebrae helps stabilize and prevents another bone spur or disc herniation from reoccurring at that level.
Common causes for a spinal condition in the cervical area include aging, sudden trauma, wear and tear, stress, chronic injuries, and arthritis. Once the compression is relieved, patients ideally experience reduced or no pain.
What does it treat?
- Herniated or bulging discs
- Degenerative disc disease
- Spinal stenosis
- Complications from herniated or bulging discs and degenerative disc disease
- Bone spurs
- Calcified ligaments
Who are good candidates?
Candidates for ACDF may have a variety of spinal conditions and symptoms. However, ideal candidates should have neck pain for at least 3 months and should experience one or more of the following symptoms:
- Chronic pain in the neck, shoulders, arms, hands, and/or fingers that is dull, deep, sharp, throbbing, shooting, or radiating
- Weakness and/or numbness in the arms, hands, and/or fingers
- Numbing or tingling sensation in the shoulders, arms, hands, and/or fingers
- History of multiple conservative methods of treatment that have failed to improve the condition or symptoms of the condition
Ideally, patients should be optimistic towards improvement and are aware of any physical rehabilitation that may be needed as part of their aftercare.
What is the procedure like?
Patients will be under general anesthesia, and their orthopedic spine surgeon or neurosurgeon will perform the procedure. Depending on the complexity of the patient's condition, ACDF may take between 1 to 3 hours to complete.
The following are the general steps of ACDF:
- The surgeon begins by prepping the area on the neck for the incision. If the patient prefers the bone graft to be of their own bone, then the hip area will be prepped for a small bone extraction.
- After making the small incision in the front of the neck, the soft tissues of the neck are carefully separated to expose the affected disc.
- The disc is removed under an operating microsope so that the spinal nerve and/or the spinal cord are decompressed. Any present bone spurs or calcified ligaments are removed. If applicable, the bone graft extraction will now occur.
- The bone graft is then inserted into the space where the disc was. For support and aiding in fusion, a metal plate bridged across the fusion with screws may be attached to either end of the adjacent vertebrae.
- The surgeon then closes the incision(s) with invisible sutures and the procedure ends.