The cervical spine is made up of the first seven vertebrae below the skull and the discs that lie between them. Changes to these discs, as with degenerative disc disease or herniated disc, can result in neck pain.
Nonsurgical treatment methods are available for degenerative disc disease and herniated discs in the cervical spine. However, if nonsurgical treatment methods do not relieve your pain and other symptoms associated with these conditions, anterior cervical discectomy and fusion (ACDF) may be an option for you.
What is ACDF?
During an anterior cervical discectomy and fusion, your surgeon makes an incision at the front of the neck, also called the anterior. Spine surgeons approach the spine from the posterior, or back, during procedures in the lower or mid-back, but the anterior approach allows for better access to the cervical spine.
Once your surgeon gains access to your spine through the front of the neck, he will carefully remove the damaged disc to relieve pressure on the nerve root. This process is known as a discectomy. If any bone spurs are present on the vertebrae above and below the disc space, they may be removed as well.
Once the discectomy is complete, the vertebrae above and below the disc space will then be fused together. To perform a fusion, your surgeon places a bone graft or synthetic spacer between the two vertebrae to fill in the space where the disc once was. Bone grafts can be taken from the pelvic bone but are typically taken from a bone bank (tissue bank) to spare the potential pain and associated morbidity with harvesting a graft from the hip bone (ilium). As you heal, the bone graft or synthetic spacer will cause the two vertebrae to grow together, resulting in a fusion.
What are the benefits of ACDF?
The anterior approach provides your surgeon better access to the cervical spine when compared with the posterior approach. Your surgeon can access nearly the entire cervical spine through the anterior approach, and only one muscle needs to be cut to gain access.
Because there is less manipulation and cutting of the muscles when compared with a posterior procedure, patient usually experience less pain after the procedure. Although it can take several months for the bones to completely fuse together, reduced postoperative pain can make recovery easier for the patient.
Who is eligible for ACDF?
An examination by one of our physicians is needed to determine whether you are a candidate for anterior cervical discectomy and fusion. Candidates for ACDF have degenerative disc disease or a bulging or herniated disc in the cervical spine. Surgery may be considered an option for these patients if the condition causes significant pain or weakness in the neck or arm, and nonsurgical methods have not relieved these symptoms.
What can you expect before and after the procedure?
Prior to an ACDF, your doctor may order pre-surgical tests to ensure that it is safe to move forward with the procedure. You should also let your doctor know which medications you are taking, as you may need to stop some of them before the procedure. Blood thinners and nonsteroidal anti-inflammatory medications like ibuprofen and naproxen should be stopped before the procedure.
If you smoke or chew tobacco, it is advised that you quit before undergoing the procedure. Nicotine can contribute to complications after the procedure. Nicotine inhibits bone growth, and the vertebrae may not fuse together properly. Smoking also results in decreased blood circulation, which can slow wound healing and increase your risk of an infection.
Following the procedure, it is important that you follow all instructions given to you by your surgeon. These instructions will help to ensure that you get the best possible result from the procedure. Some activities may be restricted for several weeks, and you may need to avoid certain medications while you heal. Anti-inflammatories such as Alleve, Motrin, Ibuprofen, Naprosyn should be avoided in the early postoperative period as they have been shown to inhibit fusion. Do not resume any activities or medications until your doctor approves.
Anterior Cervical Discectomy and Fusion in Austin, TX
At Austin Spine, we offer a full range of surgical and nonsurgical treatments for spinal problems, including degenerative disc disease and herniated disc of the cervical spine. If you would like to learn more about ACDF at Austin Spine or schedule a consultation with one of our board-certified specialists, please call our office at (512) 347-7463.