What Is Anterior Cervical Discectomy and Fusion (ACDF)
Anterior Cervical Discectomy and Fusion (ACDF) is a common surgical procedure to treat nerve root and/or spinal cord compression secondary to disc herniation or bone spur formation. This procedure is also used to repair cervical spine injury secondary to trauma. This procedure is used when other non-surgical treatments have failed.A cervical disc may be injured/damaged or may degenerate which may cause spinal cord or nerve root compression. This nerve root may become inflamed and cause pain, and neurological dysfunction including weakness and numbness.
After general anesthesia, a small incision is made on the anterior surface of the right or left side of the neck in order to reach the spine. The damaged disc is identified with x-ray guidance and is subsequently removed in order to decompress the spinal cord and nerve roots. Arthritic bone spurs are also removed. The intervertebral foramen, the bone channel through which the spinal nerve exits, is then enlarged with a small instrument giving the nerve more room to exit the spinal canal.
To prevent the vertebrae from collapsing and to increase stability, the open space is often filled with bone graft, or PEEK spacer. The process of the bone graft joining the vertebrae together is called “fusion”. Sometimes a titanium plate and or screws are utilized to increase stability during fusion.
The surgery may be performed on an outpatient basis or with a 1-2 day hospital stay depending upon surgeon and patient preferences and requirements. Generally, a patient may return to office work in 2-6 weeks, individual restrictions may vary.
Types of Bone Graft
Autograft– Bone graph comes from the patient. The surgeon takes your own bone cells from the hip (iliac crest). This graft has a higher success rate of fusion because it has bone-growing cells and proteins. Harvesting a bone graft from your hip is done at the same time as the spine surgery. The harvested bone is about a half inch thick.
Allograft– The bone comes from a donor (cadaver) and is collected from people who have agreed to donate their organs after they die. This type of bone graft does not have bone-growing cells or proteins, yet it is readily available and eliminates the need to harvest bone from your hip. The center of the allograft filled with shavings of living bone tissue taken from your spine during surgery.
Bone Graft Substitute– This type of graft is made of plastic, ceramic, or bioabsorbable substitute materials. Also called cages, bone graft material is filled with shavings of living bone tissue taken from your spine during surgery.
Facts About Spinal Degeneration:
- The discs of the spinal column usually allow comfortable movement. But age, injuries, and some degenerative conditions, such as arthritis, can cause damage to the discs.
- The discs may thin, dry out, or swell and bulge, resulting in inadequate cushioning. When discs become damaged, this is called degeneration. Discs can also swell or break open, which is called herniation.
- Sometimes the pain causes muscle stiffness and soreness. It can also radiate to other areas of the body, causing headaches, back, and shoulder pain.