Introduction

Anterior Cervical Discectomy and Fusion (ACDF) is performed to remove pressure off of one or more nerve roots and/or the spinal cord.

This procedure commonly is used to treat cervical disc herniations, cervical spinal stenosis, cervical degenerative disc disease, cervical myelopathy, and cervical spondylosis.

Anterior Cervical Discectomy and Fusion surgery has a very high success rate in alleviating radiating pain in the arm(s) and scores high in satisfaction for the appropriately selected patient. In fact, under the most ideal of circumstances which is a single level disc herniation, in a healthy, active individual, success rates approach 95%. This procedure can be performed on an outpatient basis for many patients. While new types of instrumentation and implants continue to be developed, the overall ACDF technique continues to be the gold standard approach for many degenerative conditions of the cervical spine.

As with any surgical procedure, there are potential risks and benefits that should be discussed and considered.

Last modified: October 22, 2019

Description of Procedure

This surgery is performed under general anesthesia. Once you are comfortable and asleep, you will be positioned on your back. Live x-ray is used to localize the area of your incision.

A small incision will be made along the anterior (front) side of your neck going slightly to the left side. A plane is entered between layers of muscle that allows for access down to the level of bone (front of the neck). Once the correct disc is identified, a discectomy is performed to remove a majority of the disc from the front of the neck. The decompression can then be performed which allows the surgeon to remove any pressure off of the nerve roots and/or spinal cord from disc material or bone spurs.

Once decompressed, a piece of bone (allograft) will be cut and placed in each disc space where the disc has been removed. The bone will be tailored to fit this space and re-create the original height of the disc that occupied this space. This is performed to stabilize the spine and eventually create a fusion. A small titanium plate will then be placed over the front of the neck bones and secured with small screws to create a rigid environment and limit motion so that the bones can fuse together.

The advantage of this approach is that it allows the surgeon direct access to the level of the disc and bone while only having to split a minimal amount of muscle. This helps limit post-operative pain.

Last modified: October 22, 2019

FAQ's

Last modified: October 22, 2019

Risks

Some of the risks and complications associated with this procedure include:

• Wound infection


• Hematoma


• Damage to carotid artery resulting in excessive bleeding or stroke


• Nerve injury including paralysis


• Loss of bowel or bladder function


• Difficulty swallowing


• Hoarseness (temporary or permanent)


• Hardware failure including loosening of screws


• Pseudoarthrosis (failure to fuse)


• Blood clots


• Development of degeneration at segment above or below fusion


• Numbness (temporary or permanent)


• Incomplete relief of symptoms


• Risks associated with anesthesia

Last modified: October 22, 2019

Evidenced Based Links

• http://www.spineopedia.com/article/radiculopathy-and-myelopathy-at-segments-adjacent-to-the-site-of-a-previous-anterior-cervical-arthrodesis/

Last modified: October 22, 2019