Anterior Cervical Decompression & Spine Fusion?
Anterior Cervical Decompression and Fusion is used to treat a herniated disc or spinal stenosis. These conditions can result in a pinched nerve or compressed spinal cord, the effects of which may include pain, weakness, tingling, balance trouble, difficulty walking, or numbness.
The ACDF Procedure
An ACDF is generally performed using an anterior approach, which provides a relatively uncomplicated pathway to the surgical site. This simply means that the surgery is done through the front of the neck, rather than the back of the neck. The spinal disc is positioned to the front of the spinal cord, so approaching it from the anterior (front) side is safer. The small horizontal incision is often placed inside a preexisting skin crease, for cosmetic reasons. When a multilevel procedure is done, a vertical incision is required.
The thin muscle inside the skin is then cut along the same incision lines, and access is gained by cutting away a portion of the fibrous tissue, called the pre-vertebral fascia, which encases the spine. During this part of the procedure, careful limitation of muscle dissection helps reduce postoperative pain.
An incision is made in the outer coating of the disc, then the soft inner core of the disc is removed. After the surgeon examines the longitudinal ligament (which may be removed to access the spinal cord) and removes any bone spurs or discs that may extrude through the ligament, a bone graft or a “cage” is inserted where the disc once resided. This “cage” will prevent the disc space from collapsing. The bone fusion will eventually heal back together, but can take up to 18 months. During this recovery time, a metal plate is affixed to the upper and lower vertebrae to provide stability.
Recovery after ACDF
Most patients report significant reduction of arm pain after ACDF, but symptoms like numbness and gait problems may require longer recovery times. Neck movement will rapidly improve, as pain from joints and pinched nerves is relieved. Patients typically return home the day after surgery.