An anterior cervical discectomy is the most common surgical procedure to treat damaged cervical discs. Anterior cervical discectomy and fusion (ACDF) is a surgical procedure performed to remove a herniated or degenerative disc in the cervical (neck) spine. Its goal is to relieve pressure on the nerve roots or on the spinal cord by removing the ruptured disc. Discectomy literally means “cutting out the disc.” A discectomy can be performed anywhere along the spine from the neck (cervical) to the low back (lumbar). The surgeon reaches the damaged disc from the front (anterior) of the spine through the throat area. By moving aside the neck muscles, trachea, and esophagus, the disc and bony vertebrae are accessed. In the neck area of the spine, an anterior approach is more convenient than a posterior (back) because the disc can be reached without disturbing the spinal cord, spinal nerves, and the strong neck muscles of the back. Depending on your particular case, one disc (single-level) or more (multi-level) may be removed. Sometimes the space between the vertebrae are left open. However, in order to maintain the normal height of the disc space, the surgeon may choose to fill the space with a bone graft.
A bone graft is a small piece of bone, either taken from the patient’s body (usually from the pelvic area) or from a bone bank. This piece of bone fills the disc space and ideally will join or fuse the vertebrae together. This is called fusion. It usually takes a few months for the vertebrae to completely fuse. In some cases, some instrumentation (such as plates or screws) may also be used to add stability to the spine.
Why Do I Need This Procedure?
If you have a herniated disc, this means that the nucleus pulposus – the soft, gel-like center of the disc – has pushed through the annulus fibrosus, the disc’s tough, outer ring. Bone spurs, also called osteophytes, can form when the joints of the spine calcify.
Pressure placed on nerve roots, ligaments or the spinal cord by a herniated disc or bone spur may cause
- Pain in the neck and/or arms
- Lack of coordination
- Numbness or weakness in the arms, forearms or fingers
Pressure placed on the spinal cord as it passes through the cervical spine can be serious, since most of the nerves for rest of the body (e.g., arms, chest, abdomen, legs) must pass through the neck from the brain. A cervical discectomy can ease pressure on the nerves, ultimately providing pain relief.
An anterior cervical discectomy with spinal fusion is typically recommended only after non-surgical treatment methods fail. Your surgeon will take a number of factors into consideration before making this recommendation, including the condition to be treated, your age, health and lifestyle and your anticipated level of activity following surgery. Please discuss this treatment option thoroughly with your spinal care provider.
How Long Will It Take Me To Recover?
Your surgeon will have a specific post-operative recovery/exercise plan to help you return to your normal activity level as soon as possible. The amount of time that you have to stay in the hospital will depend on this treatment plan. You typically will be up and walking in the hospital by the end of the first day after the surgery. Often patients are encouraged to maintain a daily low-impact exercise program. Walking, and slowly increasing the distance each day, is the best exercise after this type of surgery. Some discomfort is normal, but pain is a signal to slow down and rest. You may return to work in 3-6 weeks, depending on how well your body is healing and the type of work/activity level you plan to return to.
Work closely with your spinal surgeon to determine the appropriate recovery protocol for you, and follow his or her instructions to optimize the healing process.