Anterior cervical discectomy and fusion (ACDF) is a relatively common surgery that is performed by both neurosurgeons and orthopedic spine surgeons in order to eliminate or reduce chronic pain in the back and neck that is due to disc issues.
ACDF removes a herniated (sometimes called a slipped disc) or degenerative disc or bone spurs from the neck. A herniated disc occurs when the disc’s soft material in its center is pushed out through the disc’s firmer material on the outer edge.
After the herniated disc is removed, a metal plate and screws are then implanted to hold the vertebrae (between the removed discs) together. The vertebrae then will fuse with nearby bone which will stabilize the cervical vertebrae.
The surgery is anterior as the disc is accessed through the front of the neck, rather than through the back, by the surgeon.
ACDF surgery has a very high success rate. According to PubMed.gov (a highly respected database from the National Institutes of Health), between 93 to 100 percent of those who have had ACDF surgery performed for arm pain reported relief from that pain, and 73 to 83 percent of those who have had ACDF surgery for neck pain reported positive results.
Despite the high success rates associate with ACDF surgeries, it is usually a last resort once other treatments such as medications or physical therapy have failed to relieve the pain because the surgery is very invasive and requires a long recovery time that may significantly affect one’s life.
What is ACDF surgery used for?
ACDF surgery is used to:
- remove a worn down or injured disk in your spine.
- remove bone spurs on your vertebrae that pinch your nerves, which can make your arms or legs feel weak or even numb.
- treat a herniated or slipped disk.
What kind of accidents lead to ACDF surgery?
A spinal injury can occur as a result of almost any type of accident. Common accidents that lead to spinal injuries can include:
What kind of conditions might require ACDF surgery?
The following conditions may require spinal fusion surgery:
- Bone fracture
- Herniated discs
- Spinal deformities
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Who is a good candidate for ACDF surgery?
ACDF offers hope to people who live with chronic pain, numbness, or weakened mobility. ACDF is an option in cases where there is a herniation or degeneration of a disc(s), there’s significant weakness in one’s hand or arm, and where symptoms have not improved with physical therapy or medication.
What happens during ACDF surgery?
The spine is made of small bones that are stacked on top of each other, called vertebrae. The vertebrae protect and encapsulate the spinal cord, which sends nerves to various parts of the body.
Between each vertebra of the spinal column is a cushion called an intervertebral disc. Intervertebral discs are made of a flexible outer wall, called an annulus, which is filled with a jelly-like fluid, the nucleus. Intervertebral discs act as shock absorbers during falls, exercise, and other activities. Intervertebral discs prevent the bones from grinding against one another.
When these discs become damaged, protruding due to an abundance of nucleus fluid, it can press on nerves leading from the vertebrae. These discs can then cause pain ranging from moderate to intense.
Spinal fusion surgery alone is a surgical method that joins two or more vertebrae to limit motion. The idea is that pain can be reduced by limiting motion and providing structure for damaged or deteriorating spinal vertebrae. Spinal fusion uses supplementary bone tissue, from either the patient or a donor, and grafts it to the body’s natural bones.
Fusion became an accepted treatment for deformities, fractures, and dislocations. However, surgeons later expanded it as a treatment for back pain.
ACDF combines this method of spinal fusion with a discectomy, alternatively known as a diskectomy. An ACDF procedure can be performed on any of the discs in between the seven cervical bones.
During ACDF surgery, the surgeon will access the spinal column through the throat, instead of the back of the neck which can harm the neck muscles and spinal column. The tissue inside the neck and throat is moved aside to access the spine and the damaged discs are removed completely. Any material pressing on the nerve or spinal cord is also removed.
To prevent the vertebrae from collapsing and to ensure that the spine is aligned, at least two bones are fused before replacing the disc.
Disc replacement includes several options:
- bone graft – bone is attached to the area to replace the disc. The bone can be from one’s own neck (autograft), or from a donor (allograft).
- bone graft substitute – similar to a bone graft, this method uses human-manufactured materials.
- Arthroplasty – the disc is replaced with an artificial disc.
With a bone graft, a titanium plate and screws are used to attach the bones and to provide stability until the bones eventually grow together.
After ACDF Surgery
Most people with damaged discs do not experience pain or need surgery. However, ACDF surgery is an option in cases where there is:
- a herniation or degeneration of disc(s)
- significant pain, weakness, or tingling in one’s hand or arm
- pain due to pinched spinal nerves
- no improvement with other treatments such as physical therapy, medication, injections, or exercise.
Ultimately ACDF surgery is a decision each patient needs to make with their doctor, so it is important to consult a medical professional to determine the best course of treatment for your condition.
Final Thoughts on ACDF Spinal Fusion Surgery
Because spinal fusions are so invasive and require months of recovery, this type of surgery is commonly used as a last result.
Even though recovery from ACDF may take a long time, ACDF surgery is highly successful and can help you regain control of your neck and limb movement, relieving pain and weakness which can allow you to return to many daily activities.
ACDF surgery can carry lifelong pain and symptoms that require prolonged recovery time, missed time from work, and expensive future medical treatments. Some individuals might also need additional surgeries or other treatments.
If you suffered a serious back injury or spinal cord injury that required you to undergo a spine fusion surgery, or your doctor has recommended that you should have a spinal fusion surgery after an accident, you should speak to personal injury lawyers at Dolman Law Group, PA to explore your legal options.
Contact us today to schedule a free consultation at 727-451-6900.