Anterior Cervical Discectomy & Fusion (ACDF)
How Cervical Radiculopathy Occurs
Cervical radiculopathy occurs when one of more of the nerves in the cervical (upper) vertebrae is compressed. When this happens, patients can have pain and numbness not just in the neck, but the pain can also extend down your arms and into the chest and shoulders. Sometimes, the pain becomes so severe that it affects the ability to hold or grasp something with your hands.
Causes of Cervical Radiculopathy
The condition can result from a ruptured disk, arthritis or other degenerative condition or injury. Most often, degenerative disease is the cause of pain in middle-aged and older adults, but in younger people, the pain is normally due to injury or accident.
Treatment for Cervical Radiculopathy
Your orthopaedic surgeon will first try to treat this condition with a combination of anti-inflammatory medications — such as steroids or non-steroidal anti-inflammatory drugs, along with physical therapy to try to relieve pain and help increase mobility. However, if you have significant compression on the nerve that causes motor weakness, you may have to have surgery to relieve the pressure.
Benefits of ACDF
Anterior cervical discectomy and fusion (ACDF) helps to realign the spine, giving space for the nerve roots that travel from the spine to the arms, shoulders and chest, and limits movement in the damaged portion of the spine.
How ACDF Surgery is Performed
The surgery site is accessed from the front (anterior) of the neck. A small incision is made in the neck crease to minimize scaring. The surgeon removes the disc that is pressing on the nerves and stretches the area to help ensure that the space is maintained. A bone graft — normally from the patient’s hip — is inserted into the space, which helps stimulate bone healing and helps the fusion form into a solid bone. Once the graft is put in place, the two vertebrae beside the removed disc are fused together. In some cases, pins and plates are used to stabilize the site. Fusion, which eliminates movement between the discs, lessens pain in the region.
Learn What to Expect from Anterior Cervical Discectomy and Fusion (ACDF)
Surgery
Prior to Surgery
- Talk to your doctor about any medications/vitamins/herbs you are taking as you may need to stop certain ones before surgery.
- Let your doctor know if you are pregnant or could be pregnant
- Discuss any possible bleeding disorders or other medical conditions you may have.
- You will have blood samples taken in case you need a blood transfusion.>
- You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), Clopidogrel (Plavix), warfarin (Coumadin), and other blood thinners.
- Ask your doctor which drugs you should still take on the day of the surgery.
- Do not smoke, so you can recover quicker.
Day of Surgery
- You will usually be asked not to drink or eat anything after midnight the night before the surgery.
- Take the drugs your doctor told you to take with a small sip of water.
- Your doctor or nurse will tell you when to arrive at the hospital.
- Wear comfortable clothing.
After Surgery
Most patients will remain in the hospital for one to two days.
- The surgical site in your neck will be sore for a few days.
- You will be encouraged to walk as soon as you are able as this will help speed your recovery.
- You may need to wear a soft or rigid collar for four to six weeks. This helps provide support to the surgical site.
- You will gradually begin range of motion exercises and undergo physical therapy to help with your recovery.>
- While most patients feel better within a couple of weeks, it will take up to four months before you will be able to return to full activities.
Recovery: What to Expect in the Next Few Weeks
Most patients will feel better within a couple of weeks; however, do not lift, push or pull any heavy objects until after your doctor says it is OK. Healing from a fusion can take up to a year. The bone graft must be incorporated and fuse the vertebrae together. You will have x-rays at intervals to check on the healing and during that time your activities will be restricted.
Anterior Cervical Discectomy & Fusion Q&A
Below, find answers to commonly asked questions. Click each item to expand the Q&A for each section.
The Procedure
Q: What do these procedures involve?
The surgery site is accessed from the front (anterior) of the neck. A small incision is made in the neck crease to minimize scaring. The surgeon removes the disc that is pressing on the nerves and stretches the area to help ensure that the space is maintained. A bone graft is inserted into the space to stimulate bone healing and to help the fusion form into a solid bone. It also increases the space for the nerve to leave the spine. Once the graft is put in place, the two vertebrae beside the removed disk are fused together. In some cases, pins and plates are used to stabilize the site. Fusion, which eliminates movement between the discs, lessens pain in the region.
Length of Time
Q: How long is the procedure?
It depends on the complexity of the repair and how many vertebrae are fused.
Recovery Time
Q: What is the recovery time?
Recovery is patient dependent but allow four months for full recovery and up to a year for the bone graft to completely heal. Until then, patients have to avoid certain activities. Your doctor can advise what you can expect based on your health status and on your expected surgical repair.
Pain Relief
Q: How do I know if this procedure will relieve my pain?
Removing the problem disk and fusing the vertebrae in place helps in two ways — it restores alignment in your spine and maintains space between disks so that your nerves leaving the region are not being compressed. You will have decreased pain and numbness.