Anterior cervical discectomy and fusion (ACDF) is a surgical procedure which aims to treat a damaged disc in the cervical area of the spine. ACDF is a very effective surgery which allows treating two possible conditions:
Disc herniation
Gel-like material inside the disc can protrude or break through a weak area in the surrounding wall, causing different symptoms such as irritation and swelling.
Degenerative disc disease
The discs can wear out naturally causing bone spurs to form and facet joints to swell. The discs dry and shrink, losing their flexibility and damping properties. Mild cases of cervical spondylosis often do not require treatment or may respond to conservative treatment. The most severe cases of cervical spondylosis may require treatment ranging from neck traction to stronger medications and even surgery. In most cases, this surgery requires a hospital stay of 1 to 3 days and the recovery time takes between 4 to 6 weeks.
Indications for the ACDF
The patient can be a candidate for Anterior cervical discectomy and fusion (ACDF) surgery if:
-You have significant weakness in your hand or arm.
-You have pain in your arm that is worse than in your neck.
-It has not improved with physiotherapy or medication.
-Diagnostic tests (MRI, CT, myelogram) show a herniated or degenerative disc.
How is the ACDF procedure?
The patient is placed on the back and after the administration of anaesthesia, a small incision is made on the right or left side of the neck. The trachea and esophagus move towards the center and the carotid artery and jugular vein move to the side. When the surgeon visualizes the spine, it removes approximately 2/3 of the disc using small gripping tools and then looks through a surgical microscope to remove the rest of the disc. The posterior longitudinal ligament, which is located behind the vertebrae, is removed. A titanium plate allows to secure the bone plug and provide some additional stability until the bone graft causes a fusion. There are some cases in which it may be preferable to use the patient’s own bone. The operation is performed and the incision is closed with stitches.
What are the risks of ACDF?
No surgery is risks free. In addition to the common complications such as bleeding, infection, blood clots, neurological deterioration and reactions to anaesthesia that are possible after any operation, there are some specific complications of this operation. We can mention fusion problems, swallowing disorders, thrombophlebitis (in which clots form in the veins of the legs), nerve damage, and implant fractures.
Recovery
Recovery usually lasts 4 to 6 weeks. X-rays may be taken after several weeks to verify that fusion is occurring.
Although patients often do not like it, a neck or cervical brace is sometimes used during recovery. It provides support and limit movement. After this period a patient should gradually return to normal activities. Fatigue is common and expected. Walking is a good option. Most patients reported that an early exercise program of gentle stretching, conditioning and strengthening could be very beneficial.
At the London Spine Unit, we have some of the most qualified specialists to perform ACDF. Book an appointment to get a checkup.
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Indications for the ACDF
You can be a candidate for ACDF surgery if you have significant weakness in your hand or arm, you have pain in your arm that is worse than in your neck, it has not improved with physiotherapy or medication. Also, if diagnostic tests (MRI, CT, myelogram) show a herniated or degenerative disc.
How is the ACDF procedure?
The patient is placed on the back and after the administration of anaesthesia, a small incision is made on the right or left side of the neck. The trachea and esophagus move towards the center and the carotid artery and jugular vein move to the side. When the surgeon visualizes the spine, it removes approximately 2/3 of the disc using small gripping tools and then looks through a surgical microscope to remove the rest of the disc. The posterior longitudinal ligament, which is located behind the vertebrae, is removed. A titanium plate allows to secure the bone plug and provide some additional stability until the bone graft causes a fusion.
What are the risks of ACDF?
No surgery is risks free. In addition to the common complications such as bleeding, infection, blood clots, neurological deterioration and reactions to anaesthesia that are possible after any operation, there are some specific complications of this operation. We can mention fusion problems, swallowing disorders, thrombophlebitis (in which clots form in the veins of the legs), nerve damage, and implant fractures.
Recovery
Recovery usually lasts 4 to 6 weeks. X-rays may be taken after several weeks to verify that fusion is occurring. Although patients often do not like it, a neck or cervical brace is sometimes used during recovery to provide support and limit movement. After this period a patient should gradually return to normal activities. Fatigue is common and expected. Walking is a good option. Most patients reported that an early exercise program of gentle stretching, conditioning and strengthening could be very beneficial.