ACDF – Anterior Cervical Discectomy and Fusion
The first 7 vertebrae at the top of the spine form the cervical spine, also known as the neck. In addition to connecting your head to your spine, the cervical area is a nexus of activity. Spinal nerves emanate from your neck up to your head, down to your diaphragm, and out to the tips of your fingertips. Vertebral arteries in the cervical spine supply blood and oxygen to the brain. The cervical region also has the widest range of motion of any part of the spine.1
All of which is to say, there’s a lot of opportunity for wear and tear on the cervical spine–and a lot of ways it can cause pain or discomfort when that wear occurs. When a nerve root here becomes compressed or irritated, it’s more than a pain in the neck. It can produce a condition called radiculopathy, sending pain signals radiating out from the neck through arms and hands, often combined with weakness and numbness. When the spinal cord is compression, it creates a similar condition called myelopathy, causing weakness of upper and/or lower extremities, loss of coordination and risk of disability.
How can an ACDF help?
When non-surgical alternatives have consistently failed to relieve your pain, an ACDF may be indicated. You may have heard an ACDF defined either as Anterior Cervical Discectomy and Fusion or as Anterior Cervical Decompression and Fusion. The distinction is between what it does and how it does it.
What it does
- The goal of an ACDF surgical procedure is to get to the root of the problem by decompressing the nerve root or spinal cord in the affected area.
How it does it
- This is accomplished by removing the intervertebral disc (the cushioning material between the vertebrae) that’s causing the problem. This is commonly referred to as a discectomy.
That’s how an ACDF got its name. And that’s how it can relieve a multitude of cervical spine issues.
Who can be helped by an ACDF?
An ACDF can help patients who have suffered an injury or trauma to the neck, as well as those who have been diagnosed with spinal stenosis, degenerative disc disease or arthritis of the cervical spine. Other possible indications include tumors or cervical deformity.
The most important factor in considering whether or not to have ACDF surgery, however, is the severity of the symptoms from these spinal issues.
- Is there neurological impairment or significant weakness in your hand or arm?
- Does you arm hurt more than your neck?
- Have pain medications and physical therapy failed to reduce your symptoms?
Then ACDF surgery could be the best option. In cases of myelopathy with spinal cord compromise, only surgery may help.
How is the ACDF procedure performed?
The ACDF procedure is performed from the front of the neck where the vertebrae and disc are most accessible and can be reached without disturbing the spinal cord. The surgeon makes a small incision on the side of the neck and works between the esophagus/trachea complex on one side and carotid artery on the other side. These structures are carefully protected during the surgery.
Once the diseased or damaged disc is removed, any bone spurs that press on nerve roots are also removed. The empty disc space is filled with bone graft to maintain the proper disc height. A fusion occurs when the bones grow together and create a bond between the two vertebrae. However, it can take up to a year for the vertebrae to be fully fused.
In the interim, immediate stability for the cervical spine is maintained by placing a titanium plate over the bone graft. The plate is attached to the affected vertebrae using tiny screws.
What to expect from ACDF surgery?
Soon after you wake up from surgery, a physical therapist will assist you in sitting up and walking around. Depending on the extent of your surgery (1 or 2 level fusion), you may be able to go home the same day. At most, you will spend one or two nights in the hospital.
Expect to wear a neck collar from 6 weeks to 3 months depending on the extent of your surgery. You may have a sore throat or difficulty swallowing for a week or two. But overall, there is not much pain associated with this surgery.
Unless there is irreversible nerve damage or spinal cord damage present prior to surgery, the ACDF procedure has a very high success rate for relieving arm pain, weakness and numbness.
Are You a Candidate for ACDF?
Have you had from persistent pain or numbness in your arms or hands for 6 months or longer? Have you tried conservative treatments with no relief? Have you been diagnosed with degenerative disc disease, radiculopathy or myelopathy? Then you may be a perfect candidate for a minimally invasive ACDF procedure.
Or call 727-MY-SPINE to talk to a patient care specialist.