Anterior Cervical Discectomy and Fusion Surgery
What is ACDF Surgery?
Anterior cervical discectomy and fusion (ACDF) is a type of neck surgery to remove a herniated or degenerative disc in the neck. A small incision is made in the throat area to reach and remove the disc. A graft is inserted to fuse together the vertebrae above and below the disc. A discectomy is a form of surgical decompression, so the procedure may also be called an anterior cervical decompression. Discectomy literally means “cutting out the disc.” ACDF surgery may be an option if physical therapy or medications fail to relieve your neck or arm pain caused by pinched nerves.
The surgery has 2 parts:
Anterior Cervical Discectomy: The surgery is approached through the anterior, or front, of the cervical spine (neck). The disc is then removed from between two vertebral bones
Fusion: A fusion surgery is done at the same time as the discectomy operation in order to stabilize the cervical segment. A fusion involves placing bone graft and/or implants where the disc originally was in order to provide stability and strength to the area.
Types of Bone Grafts:
Bone grafts have different advantages and disadvantages based on the sources they are coming from.
Autograft Bone: The surgeon takes your own bone cells from the hip (iliac crest) for the autograft. This graft has a higher rate of fusion because it has bone-growing cells and proteins. The disadvantage is the pain in your hipbone after surgery. Harvesting a bone graft from your hip is done at the same time as the spine surgery.
Allograft Bone: This graft comes from a donor (cadaver). Bone is collected for the bone-bank from people who have agreed to donate their organs after they die. Allograft is shaped like a donut and the center is packed with shavings of living bone tissue taken from your spine during surgery.
Bone Graft Substitute: This graft comes from man-made plastic, ceramic, or bioresorbable compounds. Often called cages, this graft material is packed with shavings of living bone tissue taken from your spine during surgery.
Benefits of ACDF Surgery:
An ACDF surgery is done with an anterior approach, which means that the surgery is done through the front of the neck as opposed to through the back of the neck. This approach has several typical advantages:
Direct Access To The Disc: The anterior approach allows direct visualization of the cervical discs, which are usually involved in causing the stenosis, spinal cord or nerve compression, and symptoms. Removal of the discs results in direct nerve and spinal cord decompression. The anterior approach can provide access to almost the entire cervical spine, from the C2 segment to the C7-T1 Level.
Less Post-Operative Pain: Spine surgeons often prefer this approach because it provides access to the spine through a relatively uncomplicated pathway. The patient tends to have less pain from the incisions with this approach than from a posterior operation. After a skin incision is made in the front of the neck, only one thin vestigial muscle needs to be cut, after which anatomic planes can be followed right down to the spine.
Treatments with ACDF Surgery:
This surgery is most commonly done to treat a symptomatic cervical herniated disc. It may also be done for cervical degenerative disc disease. ACDF surgery is also done to remove bone spurs (osteophytes) caused by arthritis and to alleviate the symptoms associated with cervical spinal stenosis. ACDF may be done for one level, or for more than one level, of the cervical spine.
Recovery Time:
Usually, you will have to remain in the hospital for 24 hours following this surgery, however you may be discharged the same day. Further recovery will happen over the next four to six weeks, after which you can return to light activities. Full recovery takes around two to three months. X-rays may be taken after several weeks to verify that fusion is occurring. The surgeon will decide when to release you back to work at your follow-up visit.
Success Rate:
The ACDF surgery has a high success rate. Between 93 to 100% of people who have had this surgery for arm pain reported relief from pain, and 73 to 83% of people who had ACDF surgery for neck pain reported positive results.
Complications and Risks
Commonly, aching, cramping, and soreness are experienced around the site of the surgery. Nerve pain is the most common reported symptom of failed back or neck syndrome. This means that you will experience shooting pain, tingling, or weakness in the extremity impacted by the back surgery.
If you would like to learn more about ACDF spine surgery for neck pain or other symptoms, contact Dr. Paraiso today.
