Summary
Anterior cervical discectomy and fusion (ACDF) surgery is a surgical procedure to relieve pressure on the spinal cord and/or nerve roots in the neck by removing a damaged or herniated disc from between two vertebrae in the neck. The vertebrae are then fused together to prevent them from moving and compressing nearby nerves.
ACDF surgery is used to treat a variety of spinal conditions affecting the neck area, such as herniated or degenerated discs, spinal stenosis, and cervical radiculopathy.
The surgery is performed under general anesthesia and can take a few hours to complete. Recovery time can vary depending on the extent of the surgery and the individual patient’s healing process, but typically takes several weeks to months.
What is an ACDF?
Anterior cervical discectomy and fusion (ACDF) surgery is a type of surgical procedure that is performed to relieve pressure on the spinal cord and/or nerve roots in the neck. The procedure involves removing a damaged or herniated disc from between two vertebrae in the neck and fusing those two vertebrae together to prevent them from moving and compressing nearby nerves.
During the surgery, a small incision is made in the front of the neck to access the cervical spine. The surgeon then removes the damaged disc and any bone spurs or other tissue that may be compressing the spinal cord or nerve roots. Once the disc is removed, a bone graft or a small metal plate and screws may be used to fuse the two adjacent vertebrae together, creating a stable spinal column.
Which conditions are treated with an ACDF?
Some of the conditions that may be treated with ACDF surgery include:
- Herniated disc: A herniated disc occurs when the soft material inside a spinal disc bulges out through a tear in the disc’s outer layer, putting pressure on the spinal cord or nerve roots.
- Spinal stenosis: Spinal stenosis is a narrowing of the spinal canal that can put pressure on the spinal cord or nerve roots.
- Degenerative disc disease: Degenerative disc disease is a condition that occurs when the spinal discs lose their flexibility and cushioning, leading to pain and stiffness in the neck.
- Cervical radiculopathy: Cervical radiculopathy is a condition that occurs when the nerves in the neck become compressed or damaged, leading to pain, numbness, tingling, or weakness in the arms or hands.
ACDF surgery is typically recommended for patients who have not responded to non-surgical treatments such as physical therapy, medication, or injections.
What can be expected the day of surgery?
On the day of the anterior cervical discectomy and fusion (ACDF) surgery, you can typically expect something like this:
- Pre-operative preparations: Before the surgery, you will be asked to change into a hospital gown and to remove any jewelry, contact lenses, or dentures. You may also receive an IV to deliver fluids and medications, and you may be given a mild sedative to help you relax.
- Anesthesia: ACDF surgery is typically performed under general anesthesia, which means you will be asleep during the procedure.
- Surgery: Once you are under anesthesia, the surgeon will make a small incision in the front of your neck to access the cervical spine. The damaged disc will then be removed, and the two adjacent vertebrae will be fused together using a bone graft or artificial spacer, along with plates and screws to hold them in place.
- Post-operative recovery: After the surgery is complete, you will be taken to a recovery room to be monitored as you wake up from anesthesia. You may have a small drain in your incision site to help prevent fluid buildup, and you may also have a cervical collar or brace to support your neck during the healing process.
- Hospital stay: Most patients will spend one or two nights in the hospital after ACDF surgery to ensure proper healing and to manage any pain or discomfort.
What is the recovery time following an ACDF surgery?
The recovery time after an anterior cervical discectomy and fusion (ACDF) surgery can vary depending on several factors, including the extent of the surgery, the patient’s overall health, and their ability to follow their post-operative instructions.
However, below is a general timeline of what patients can expect during their recovery
Hospital stay
Most patients will spend one or two nights in the hospital after the surgery to ensure proper healing and to manage any pain or discomfort.
Rest and limited activity
Patients are typically advised to rest and limit their activity for the first few weeks after the surgery, as excessive movement can disrupt the fusion process. Patients may need to wear a cervical collar or brace to support their neck during this time.
Physical activity
After the first few weeks, patients may begin physical therapy to help restore strength, flexibility, and range of motion to the neck and spine. Physical therapy may continue for several weeks or months, depending on the patient’s progress.
Return to work and normal activities
Patients may be able to return to work and resume normal activities after several weeks or months, depending on the type of work and the level of physical activity involved.
What are the risks of ACDF surgery?
As with any complex operation, there are several risks associated with spinal fusion surgery. Some of these risks include:
- Infection: Although surgery is performed in sterile conditions, there is always a small risk of infection
- Nerve damage: Nerves in and around the spinal cord can be damaged during the surgery.
- Damage to other surrounding tissues: Other tissues as well as blood vessels and can be damaged during the procedure
- Non-union: The vertebrae may not fuse together properly, which may require additional surgery.
- Adjacent segment disease: Adjacent segment disease can occur when the segments of the spine above or below the fused area become damaged or degenerate.
- Hardware complications: There is a risk that the hardware used to fuse the vertebrae together may become loose or cause irritation.
Is an ACDF right for me?
ACDF surgery is usually recommended after non-surgical treatments such as physical therapy, medications, or injections have failed to relieve your symptoms.
There are several factors that your doctor will consider when determining if ACDF surgery is the right choice for you, including your age, overall health, the extent and location of the damage to your cervical spine, and the potential risks and benefits of the surgery.
It is important to have a thorough discussion with your doctor, as they can provide you with more detailed information about the procedure and help you determine if it is the right choice for you.
