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ACDF: A Useful Spinal Fusion Process

I can remember my grandmother preaching, “Don’t mess with mother nature and don’t go cutting on your body!” It’s good advice in general, but what do you do when the doctor tells you that you need surgery to resolve your back pain? In the modern era, we search the internet for more information.

Forbes online posted an article in early 2011 discussing “Why You Should Never Get Fusion Surgery For Plain Back Pain.” The article generally discusses the use of spinal fusion for lower back or lumbar problems. It claims that this treatment for mere back pain is no more effective than non-surgical relief. The article discusses lower back fusion surgeries.

This led us to wonder the costs and benefits regarding this surgery for patients with cervical (upper spine) issues and its relationship to Anterior Cervical Discectomy and Fusion (ACDF).

The spine is made of small bones stacked on top of each other, called vertebrae. Spinal fusion surgery alone is a surgical method that joins two or more vertebrae to limit motion. The idea is that by limiting motion and providing structure for damaged or deteriorating spinal vertebrae that pain can be reduced. Spinal fusion uses supplementary bone tissue, from either the patient or a donor, and grafts it to the body’s natural bones.

Fusion caught on as an accepted treatment for deformities, fractures and dislocations. However, surgeons later expanded it as a treatment for back pain.

ACFD combines this method of spinal fusion with a discectomy, alternatively known as a diskectomy. The vertebrae protects and encapsulates the spinal cord, which sends nerves to various parts of the body. Within each vertebrae is a disc, made of a flexible outer wall, called an annulus, which is filled with a jelly-like fluid, the nucleus. When the disc protrudes due to an abundance of nucleus fluid, it can press on nerves leading from the vertebrae.

The disc is removed completely. Any material pressing on the nerve or spinal cord is also removed. To prevent the vertebrae from collapsing the space may be filled with a bone graft. The “fusion” refers to the process of the bone graft and vertebrae joining. In some cases a titanium plate can increase stability during fusion, especially where more than one disc has been involved.

The main difference between an ACFD and modern discectomy is the manner of operation. A discectomy alone can often be done as outpatient surgery. However, ACDFs are major surgery. Therefore you MUST consult a medical professional to determine the likelihood of success. Your doctor will best be able to explain the issues that can arise and the viability for your issues.

A search with the US National Library of Medicine via PubMed.gov for “Anterior Cervical Discectomy and Fusion Effectiveness“ resulted in a study showing that:

Neck paid was reduced between 63% to 69% in all groups

Improvements in arm pain by 73% to 75%, which were greater than 62-68% in other treatment groups

The study concluded that ACDF showed improvements in pain, function and quality of life with low rates of adverse events.

The question that most people considering this surgery is, “How will this help me?” There are a variety of medical websites that use a comment system to allow supposed patients to report their results. One sire had a cross section where patients reported a variety of results. Many reported a reduction in pain, including a person identifying themselves as ‘Peggy,’ who had C5-6 and C6-7 anterior fusion.

Peggy stated that she experienced numbness in her first finger and thumb, combined with pain in her left arm, shoulder and shoulder blade. She claims that the pain has completely gone away and that she was back to normal activity 6 weeks post-operation.

Like many others who posted on the site, Peggy expressed fear going into her surgery. However, a number of members expressed pleasure that others went through a similar experience. Of the 25 comments, only one person reported not seeing, or rather feeling, immediate results.

In the end, these sorts of decisions are between you and your doctor. However, ACDF is an option in cases where there is a herniation or degeneration of of disc(s), there’s significant weakness in one’s hand or arm, and where symptoms have not improved with physical therapy or medication.

Matthew A. Dolman is a Clearwater back pain attorney and a personal injury lawyer. If you should have any questions for concerns, call us today at: (727) 451-6900.