Anterior cervical discectomy and fusion (ACDF) is a surgical procedure aimed at alleviating spinal cord and nerve compression and/or neck pain caused by problems in the cervical spine. This procedure is typically recommended when conservative treatments fail to relieve pain stemming from a damaged disc. In this blog post, we will explore the intricacies of anterior cervical discectomy and fusion (ACDF), the recovery process, and the benefits of the surgery.
What is Anterior Cervical Discectomy and Fusion?
Anterior Cervical Discectomy
Anterior cervical discectomy is a surgical procedure that involves removing a damaged disc from the cervical spine. The term “anterior” refers to the front of the neck, where the incision is made. This approach allows spine surgeons to access the cervical discs without disturbing the spinal cord and nerve roots that lie behind them.
The Fusion Process                                Â
After the discectomy, the surgeon performs a spinal fusion. This involves placing a bone graft in the empty disc space and securing the spine with a metal plate and screws to encourage the bones to grow together, forming a single solid bone. This process stabilizes the spine and prevents further movement that could cause pain. The bone graft can be sourced from the patient’s own body, a donor, or be a synthetic substitute.
Why Undergo Anterior Cervical Discectomy and Fusion (ACDF)?
ACDF is often recommended for individuals experiencing severe neck pain, numbness, or weakness in the arms caused by pressure on the nerves or spinal cord. These symptoms are typically due to a herniated or degenerative disc. By removing the damaged disc and stabilizing the spine, ACDF can provide significant relief from these symptoms.
ACDF for Specific Cervical Levels
The cervical spine is made up of seven vertebrae labeled C1 through C7, starting at the top of the spinal column and working down to the seventh vertebrae. ACDF surgery will address two or more of these vertebrae. For example, if you see “C5-C6 ACDF” it means the surgeon is fusing the fifth and sixth vertebrae of your neck.
The length of your recovery from anterior cervical discectomy and fusion will vary based on your individual health and age, as well as which cervical levels are treated.
For example, the recovery process for a C5-C6 ACDF or C3-4 ACDF surgery may be shorter than for a C3-6 ACDF surgery. That’s because the C3-6 procedure involves four vertebrae.
Here’s a closer look at two common ACDF surgeries for specific levels:
- The C5-C6 level is a common site for ACDF surgery due to its susceptibility to degenerative disc issues and herniation. C5-C6 ACDF surgery can help alleviate symptoms associated with spinal cord and nerve root compression.
- Symptoms affecting the nerves at the C5-C6 disc may include pain, tingling, or numbness that radiates down the arm toward your thumb and weakness of the biceps (the muscle that flexes your elbow).
- A C5-C6 ACDF procedure aims to decompress the affected nerve roots and provide you with lasting pain relief and possibly reverse neurological deficits.
C6-C7 ACDF Surgery
- A C6-C7 anterior cervical discectomy and fusion involves the lower vertebrae of the cervical spine.
- Your surgeon may recommend a C6-C7 ACDF surgery if you have symptoms due to irritation of the nerves between these vertebrae. Symptoms may include pain throughout your arm, numbness or tingling radiating along the back of the arm into the middle fingers, and triceps weakness (the muscle that extends the elbow or works to perform a push-up).
Multi-Level ACDF Surgeries (e.g., C5-C7 ACDF)
- A multi-level ACDF involves removal of more than one disc with fusing of at least 3 vertebrae.
- Your surgeon may recommend a multi-level ACDF if you have symptoms produced by more than one degenerated disc. Symptoms result from irritation of more than one nerve or the spinal cord. A multi-level ACDF is a longer surgery and typically involves a longer recovery with possibility of using an external brace. As a result of fusing more of your spine, there is greater reduction of neck movement.
- The name of the procedure indicates how many discs are removed and how many vertebrae are fused. For example, a C4-C6 ACDF means that the C4, C6, and C6 vertebrae are fused together. A C5-C7 anterior cervical discectomy and fusion also involves three vertebrae, but the C5, C6, and C7 vertebrae.
- One of the biggest concerns associated with multi-level surgery is an increased risk of failed fusion since the bone has to heal across a greater surface area. Depending on what parts of the spine are fused, adjacent segment degeneration, when the disc above or below a fusion site degenerates, may also be a concern.
Benefits of ACDF Surgery
- Relief from Pain: The primary benefit of ACDF surgery is the relief from pain and associated symptoms.
- Stability: The fusion process stabilizes the cervical spine, reducing the risk of further injury.
- Improved Quality of Life: Many patients report a significant improvement in their quality of life after the surgery.
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Preparing for ACDF Surgery
Pre-Surgery Assessments
Before undergoing ACDF surgery, patients will undergo an evaluation including imaging tests like X-rays and MRIs, to determine the extent of the disc damage and amount of nerve compression. This helps the surgeon plan the procedure and select the appropriate approach for the discectomy and fusion.
Lifestyle Adjustments
Patients are often advised to make certain lifestyle adjustments before surgery. This may include quitting smoking, as it can impede the healing process, and making dietary changes to promote overall health and recovery.
Anterior Cervical Discectomy and Fusion Recovery
Immediate Post-Surgery
Recovery from anterior cervical discectomy and fusion (ACDF) varies from person to person. The procedure is often performed as an outpatient when involving one or two discs. For more extensive procedures the patients typically stay in the hospital for one to two days. During this time, they are monitored for any complications and begin to manage pain with medication.
Weeks After Surgery
In the weeks after surgery, patients can resume many of their normal activities. A neck brace may be used to support the healing process. It’s essential to follow the surgeon’s instructions during this period to ensure proper healing. Physical therapy often begins a few months after surgery to help improve function and strengthen the neck.
Long-Term Recovery
Complete recovery from ACDF can take several months to a year.  Patients are usually able to return to full activities, including sports, several months after surgery. Regular follow-up appointments with the surgeon are crucial to monitor the progress of the spinal fusion.
Post-Surgery Care and Physical Therapy
Importance of Physical Therapy
Physical therapy plays a crucial role in the recovery process after ACDF surgery. It helps patients regain lost neurological function and improve strength and flexibility in the neck. A tailored physical therapy program can address specific needs and help prevent future issues with the cervical spine.
Long-Term Management
Even after recovering from ACDF surgery, it’s important to maintain a healthy lifestyle to support spinal health. This includes regular exercise, maintaining a healthy weight, and practicing good posture. Regular check-ups with the spine surgeon are also important to ensure the continued health of the cervical spine.
Risks and Considerations
As with any surgery, there are risks associated with cervical discectomy and fusion. These can include infection, bleeding, and adverse reactions to anesthesia. There is also a risk of the bone graft not fusing properly, which may require additional surgery. However, when performed by experienced spine surgeons, the risks are minimized, and the success rate of ACDF is high.
Why Choose Neurosurgeons of New Jersey for your Cervical Discectomy and Fusion?
Neurosurgeons of New Jersey has been voted the #1 Surgical Practice in New Jersey for Neurosurgery. We proudly serve patients across the state with 11 convenient locations. Our team is composed of highly qualified doctors who are not only the best educated but also extensively practiced, holding numerous awards in neurosurgery. We accept and work with a diverse range of health insurance plans, including Aetna, Horizon Blue Cross Blue Shield, Oxford/United Healthcare, Cigna, Personal Injury Protection (PIP)/No-Fault for NJ Motor Vehicle Accidents, the Empire Plan (NYSHIP), Medicare, NJ Medicaid, and Workers’ Compensation. Even if your insurance isn’t listed, you may still be eligible for substantial coverage, ensuring that more patients can access our top-tier neurosurgical care.
Dr. Michael G. Kaiser, MD, FACS, FAANS
Dr. William S. Cobb, MD, PHD, FAANS
Dr. Gaetan Moise, MD, FAANS
Dr. Alfred T. Ogden, MD, FAANS
Dr. Jonathan Yun, MD, FAANS
About Ridgewood
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