What is Anterior Cervical Discectomy and Fusion?
Anterior Cervical Discectomy and Fusion (ACDF) is a surgical procedure that removes the degenerated or herniated disc in the neck. It involves the removal of a damaged disc to relieve the spinal cord or nerve root pressure that is causing pain, numbness, weakness, and tingling sensation. This surgery has two parts- the anterior cervical discectomy and fusion. In the anterior cervical discectomy, the herniated or damaged disc is removed from between two vertebral bones through the front or the cervical area (hence, the name). Fusion surgery is done at the same time as the discectomy. It involves placement of the bone graft or implant in the area.
What are the Benefits of ACDF?
ACDF can benefit those who are suffering from bulging and herniated disc or degenerative disc disease. A herniated disc can pose issues when the herniated material squeezes out and presses on the nerve. As with degenerative disc disease, it can cause issues when the changes on the dried out and shrunken discs lead to canal stenosis or disc herniation.
Who is a candidate for ACDF?
You may be a candidate for ACDF if:
- Your diagnostic tests (e.g. MRI, CT scan, myelogram) show degenerative or herniated disc
- You are experiencing significant weakness in your hand or arm
- Your arm pain feels worse than your neck pain
- Your symptoms are not improving even with physical therapy and medications
What to expect before ACDF surgery
There will be a series of consultations before surgery. This is to make sure that you are suitable for the procedure and you are physically prepared for it.
There will be a physical assessment where you will be asked about your symptoms, medications, and medical history. Certain tests will be prescribed before surgery. This may include blood tests, chest X-ray, and electrocardiogram.
If you are smoking, drinking alcohol, taking NSAIDs, and blood thinners, you will be asked to stop these 1-2 weeks before your scheduled procedure.
What to expect during ACDF surgery
It takes about 1 to 2 hours to complete the procedure.
You will be laying on your back all throughout the procedure. General anesthesia will be given. Once asleep, your neck area is cleansed and prepped. If your own bone will be used for fusion, the hip area will also be prepped to obtain the bone graft.
Once everything’s prepped, the surgeon makes an incision on the side of your neck. The surgeon will make a ‘tunnel’ to the spine to access the affected area. This is done by moving the muscles of the neck on the side and retracting the trachea, esophagus, and arteries.
The surgeon will also have to lift the muscles that support the front of the spine to locate the affected vertebra and disc. With the help of special tools, the surgeon then carefully removes the damaged disc.
After removing the affected disc, the surgeon prepares and places the bone graft into the “bed” between the vertebrae. The bone graft is typically reinforced with a metal plate, screwed into the vertebrae. An X-ray will be taken to confirm the placement.
The incisions are closed and the patient is taken to the recovery room.
What to expect after ACDF surgery
You will wake up in a postoperative recovery area. Your vitals (heart rate, breathing, blood pressure) will be monitored.
Once awake, you can slowly increase your activities. Depending on the type of ACDF, you may be sent home on the same day (this is usually for level 1 or 2 ACDF) or spend a few more nights in the hospital.
You will be given instructions regarding your activities, incision care, medications, and follow-ups.
If you are considering ACDF, the spine and neck specialists at South Florida Orthopaedics & Sports Medicine can help. Our board certified spine and neck specialists have years of experience in diagnosing and surgically treating neck and back pain. To get more information, and to find out if you are a candidate for ACDF, please call our office at (772) 288-2400.