Your spine is made up of a column of bones called vertebrae. Between each vertebra is a soft, gel-like cushion called a disc. These discs act as shock absorbers and allow your neck to move freely. When a disc is damaged, it can bulge or break open, putting pressure on the spinal cord or nerves. This can cause pain, numbness, and weakness in your neck, shoulders, and arms.
Anterior cervical discectomy and fusion (ACDF) surgery is a way to relieve this pressure and correct any instability in the spine. During the procedure, the surgeon makes a small incision in the front of your neck to access the spine. The damaged disc is removed, and the vertebrae above and below it are fused together with a bone graft and, in some cases, a small metal plate and screws. This creates a solid piece of bone, which stabilizes the spine and prevents the nerves from being pinched.
Why is an ACDF Procedure Done?
An ACDF procedure is typically recommended for patients who have not found relief from their neck pain with non-surgical treatments like physical therapy, medication, or injections. It’s a common treatment for a number of conditions, including:
- Herniated disc: This is when the soft center of a disc pushes through a tear in the outer layer, pressing on a nerve.
- Degenerative disc disease: This is a condition where the discs in your spine wear down over time, causing them to become thin and weak.
- Spinal stenosis: This is a narrowing of the spinal canal, which can put pressure on the spinal cord and nerves.
- Cervical radiculopathy: This is a condition where a nerve in the neck is pinched, causing pain, numbness, and weakness in the arm and hand.
- Myelopathy: This is a more serious condition where the spinal cord is compressed, causing problems with balance, coordination, and bowel or bladder control.
What to Expect During an ACDF Procedure
ACDF surgery is performed in a hospital or surgery center. You will be given general anesthesia, so you will be asleep during the procedure.
The surgeon will make a small incision in the front of your neck, usually in a skin crease to minimize scarring. The muscles and other structures in your neck will be gently moved aside to expose the spine.
The damaged disc is then removed, and the space between the vertebrae is prepared for the fusion. A bone graft is placed in the space to encourage the vertebrae to grow together. The graft may be taken from your own hip (autograft), from a donor (allograft), or it may be a synthetic material.
In some cases, a small metal plate and screws are used to hold the vertebrae in place while they fuse. The incision is then closed with stitches or staples.
The entire procedure usually takes one to three hours.
What to Expect Before and After an ACDF Procedure
Before the procedure
Before your surgery, you will meet with your surgeon to discuss the procedure in detail. They will answer any questions you have and make sure you understand the risks and benefits of the surgery.
You may need to have some tests done before the surgery, such as blood tests, an EKG, and a chest X-ray. You will also be given instructions on what to do in the days leading up to the surgery, such as stopping certain medications and not eating or drinking after midnight the night before.
After the procedure
After the surgery, you will be taken to a recovery room where you will be monitored closely. You may have a sore throat and some difficulty swallowing for a few days. You will also have some pain in your neck, which can be controlled with medication.
Most patients are able to go home the same day as the surgery or the next day. You will be given instructions on how to care for your incision and how to manage your pain at home.
You will need to wear a neck brace for a period of time after the surgery to support your neck and help it heal. You will also need to avoid certain activities, such as heavy lifting and strenuous exercise, for several weeks.
Physical therapy may be an important part of the recovery process. If indicated, a physical therapist will teach you exercises to help you regain strength and flexibility in your neck.
Most patients are able to return to their normal activities within a few months of the surgery. However, it can take up to a year for the fusion to be completely solid.
Risks of ACDF Surgery
ACDF surgery is a safe and effective procedure, but like any surgery, it has some risks. These include:
- Infection
- Bleeding
- Blood clots
- Nerve damage
- Difficulty swallowing
- Hoarseness
- Failure of the fusion to heal
Your surgeon will discuss these risks with you in detail before the surgery.
California Pacific Orthopaedics
At California Pacific Orthopaedics in San Francisco, CA, our team of experienced spine specialists is dedicated to providing you with the highest quality of care. We will work with you to develop a personalized treatment plan that is right for you. If you are suffering from neck pain, contact us today to schedule a consultation.
