Anterior cervical discectomy and fusion (ACDF) is a surgical procedure that involves relieving the pressure placed on nerve roots and/or the spinal cord by a herniated disc or bone spurs in the neck. The goal of an ACDF is to remove a herniated or degenerated disc in the neck area of the spine, then fill the resulting space with a bone graft, fusing the vertebrae together for stability.
The aim of this surgery is to relieve your pain and stabilize the cervical spine. Performing the surgery in a minimally-invasive method through the front of the neck (anterior) versus the back of the neck (posterior) allows your physician to access the discs without disturbing the spine and spinal nerves. This also allows for improved function after surgery, less blood loss, and more complete decompression of spinal nerves.
Anterior Cervical Decompression With Fusion Basics
Before performing the main portion of anterior cervical decompression with fusion, your surgeon will need to prepare material called a bone graft, which is used to fuse two of your neck vertebrae together toward the end of the procedure. Sometimes, this graft material comes from a section of your own hip bone, or from a bone bank that collects graft material from cadaver tissue donors. However, your surgeon may also choose to use an artificial graft called a cage, which can be made from ceramics, plastics or other man-made components and acts as a holder for a collection of bone shavings. A more modern option is an entire replacement disc made from artificial materials.
Anterior surgical procedures get their name because they’re performed front the front, or anterior side, of your body. In the case of anterior cervical decompression with fusion, your surgeon will begin the main part of the procedure by making a short incision to one side of the front of your neck, then carefully pulling aside your windpipe, esophagus, muscles and blood vessels until he exposes your spinal discs and vertebrae. Next, he will use a device called a spreader to hold two neighboring vertebrae in place while he pulls out the damaged disc that sits between them.
After checking to make sure he’s removed any disc fragments intruding upon your spinal cord or nearby nerves, your surgeon will place the graft material in the space formerly occupied by the disc. As your body heals, it will naturally fuse bone from the neighboring vertebrae to the bone graft and create a single, longer bony structure. In some cases, your surgeon will assist the fusion process by fixing the graft in place with metal plates or rods screwed into the vertebrae on either end of the surgical site.
Anterior Cervical Decompression With Fusion Uses
Anterior cervical decompression with fusion is commonly used to repair damage caused by a herniated spinal disc or by a disorder called degenerative disc disease, which can shrink the affected spinal disc and trigger any one of a number of structural problems. Still, doctors typically only recommend any form of surgery when these conditions last for at least six weeks after the start of nonsurgical treatment; cause significant pain in an arm as well as in the neck; and/or produce serious or progressive weakness in an arm or hand. Only 1 in 10 patients with cervical disc problems has symptoms that are severe enough and last long enough to warrant surgical consideration.
How long is recovery?
This minimally invasive ACDF is typically performed on an outpatient basis for most patients; however, the number of levels that your physician treats may require an overnight stay. As with all minimally invasive procedures, the ACDF is less likely to cause extensive scarring or require an extended recovery than traditional open back surgery. Many patients will notice immediate improvement of some or all of their symptoms; however, other symptoms may improve more gradually. Many patients who undergo an ACDF can often return to light activities within a few weeks. This can vary depending on the individual patient, number of levels treated, and other factors. Recovery will include rest, physical therapy, and a short course of pain management medication.
Anterior Cervical Decompression With Fusion Benefits
Roughly 93 percent of people who undergo ACDF without supporting plates or rods experience successful fusion of the targeted vertebrae. From a statistical point of view, almost all patients who undergo ACDF with supporting plates or rods experience successful spinal fusion. Roughly 90 to 100 percent of patients who undergo anterior cervical decompression with or without fusion experience substantial relief of their arm pain symptoms, while approximately 75 to 85 percent of this same patient group experiences substantial relief of their neck pain. Anterior cervical fusion with decompression typically provides the greatest benefits to patients with pain centered in their arms.
Anterior Cervical Decompression With Fusion Risks
Potential risks associated with performance of anterior cervical decompression with fusion include accidental injury to your windpipe or esophagus, speaking or swallowing problems related to damage in these structures, accidental injury to your spinal cord or a spinal nerve, uncontrolled bleeding, failure to relieve your symptoms, postsurgical infection and lack of adequate fusion in the grafted section of your neck. In general, you can reduce your risks for complications by working with a surgeon who has a good track record with the procedure. You can lower your specific risks for failed fusion by avoiding smoking during the months following your surgery.
Why North American Spine?
Our partnered physicians are specialized and highly experienced in minimally invasive techniques, so patients experience a quicker recovery time, better surgical outcome, and reduced post-operative risks in comparison to open spine surgeries. Also, remember that your Patient Care Manager is here to guide you the whole way—our goal is to make sure you feel informed, cared for, and comfortable throughout every step of your care.