Anterior Cervical Discetomy & Fusion (ACDF)
If you have a herniated or degenerative disc in the neck area of your spine, your doctor may recommend that you undergo a procedure known as anterior cervical discectomy & fusion (ACDF). A discectomy can actually be performed anywhere along the spine, from the neck to the lower back. Anterior cervical discectomy & fusion is simply the procedure when it is performed on the neck portion of the spine.
Anterior cervical discectomy and fusion is often recommended when physical therapy or medications fail to provide relief from neck pain or when your arm is in pain due to inflamed and compressed spinal nerves.
What is an anterior cervical discectomy & fusion?
Going through the throat area, your surgeon will access the problem area in the spine. Discectomy literally means “cutting out the disc”. As such the surgeon will move aside the muscles, trachea and esophagus to access the disc and vertebrae. The reason the doctor goes through the neck is that it provides easier access to the damaged disc. Going through the back could disturb the spinal cord and sensitive spinal nerves.
Once the disc is successfully removed, the space between the two vertebrae will be empty. To prevent them from rubbing together or collapsing, the area will be filled with a bone graft. This creates a bridge between the two vertebrae and fuses them together. Screws and metal plates hold the fused pieces together.
After three to six months, new bone cells will form around the graft and in many cases, grow over the screws and plates to create a solid area that is very strong. The bone used in the graft can come from your own body – often the hipbone – a cadaver donor or an artificial bone substitute made of plastic, ceramic or materials that can be reabsorbed into the body over time. Increasingly, artificial discs are being used instead of grafts or fusion cages. Celebration Health Spine Center is at the forefront of using artificial discs so you’ll want to ask your doctor about this option.
Who is a good candidate for ACDF?
ACDF is useful in treating bulging or herniated discs and degenerative disc disease. This can include foraminal or central stenosis or disc herniation.
Your doctor may recommend this procedure if:
- Diagnostic tests such as an MRI or CT scan show that you have a herniated or degenerative disc issue.
- There is significant weakness in your arm or hand.
- Your arm pain is worse than your neck pain.
- Symptoms have not improved significantly with medication or physical therapy.
What should I expect after surgery?
In many cases, you will go home on the same day you have your procedure. If you have any complications, such as blood pressure that won’t stabilize, you may be required to stay overnight, just so the healthcare team at the Florida Hospital Celebration Health Spine Center can keep an eye on you.
When you leave, your doctor will give you some instructions to follow. In some cases, you may notice a reduced level of mobility in your neck. This is usually due to the fusing of the vertebrae together and is to be expected.
After surgery you will be given a strong pain medication to manage any discomfort. You may find yourself a little hoarse or experience a sore throat or have problems swallowing. This is natural and should go away in one to four weeks.
If you end up having a fusion, you’ll be asked not to use any non-steroidal anti-inflammatory drugs for six months after your surgery. This includes aspirin, ibuprofen, Motrin, Advil, etc. It can cause bleeding and interfere with bone healing.
If you smoke, you will need to stop. It can increase the risk of infections and prevent the bones from fusing together.
Your surgeon may also suggest that you not drive for two to four weeks, avoid sitting for long periods of time, avoid lifting anything heavier than a gallon of milk (i.e. five pounds), and not doing any housework or yard work until you’ve seen the doctor again on a follow-up visit.
In approximately 92% to 100% of patients, the arm pain will be relieved. Neck pain subsides in 73% to 83% of all patients who undergo an anterior cervical discectomy.