Anterior Cervical Discectomy and Fusion

ACDF is the acronym for Anterior Cervical Discectomy and Fusion. ACDF surgery is performed to treat spinal cord and nerve root compression that can be caused by disorders, including degenerative disc disease, herniated disc, spinal stenosis, and spondylosis. The purpose of ACDF is to reduce neck and/or arm pain and stabilize the spine. Depending on your medical history, diagnosis, previous treatments, and other factors you may be a candidate for the minimally invasive version of this procedure.

Before your ACDF procedure

Well in advance of your surgery day, your neurosurgeon explains how he performs your procedure. During the discussion, you learn if your procedure can be performed as a minimally invasive spine surgery or open approach, and why.

Before surgery, you visit your primary care doctor or general practitioner to obtain a general health clearance. This means your doctor has carefully evaluated your health in terms of undergoing surgery. Your assessment may include blood tests, x-rays or other imaging studies, as well as special tests for existing medical problems (e.g., diabetes, heart disease).

Review potential benefits and risks of ACDF

Of course, the potential benefits of surgery are important to know, but so are the possible risks and complications. Your risks and complications may be different from those of another patient because you are unique. Your neurosurgeon takes that into serious consideration and thoughtfully explains potential risks to you, which may include infection, bleeding, reaction to anesthesia, and nerve damage.

ACDF Surgical information

Anterior cervical discectomy and fusion are performed under general anesthesia. Throughout your procedure, the neurosurgeon and his surgical team are kept current about your vital functions, including your central nervous system. Many different gauges, monitors, and equipment provide visual and audio feedback to the surgical team. Image guidance (real time x-ray; fluoroscopy) allows your neurosurgeon to see other views of the surgical field during (intra-operative) your procedure.

Basic surgical steps of ACDF

• You are positioned face up on a padded operating table.
• Real time x-rays are taken to confirm the cervical level.
• Your neurosurgeon makes an incision in the front of your neck. The skin incision may be made through one of the natural folds of your neck. This helps to disguise scarring.
• Muscle and other soft tissues are gently pulled aside to expose the intervertebral disc.*
• A discectomy is performed to remove all or part of the disc.
• The disc space is prepared to receive a block of bone or cage(s) to fill the space. Depending on the type of interbody device, it may be filled with bone graft.
  

  Bone graft type	What it is
  Autograft	Bone from your body
  Allograft	Donor bone

• If necessary, the spinal cord and/or nerve roots are further decompressed by trimming away bony overgrowths (bone spurs, osteophytes), thickened ligament and/or other tissues.
• Restoring the disc space between the upper and lower vertebral bodies can help to decompress neural structures by enlarging the natural nerve pathways.
• Additional bone graft is packed around the disc space.
• A cervical plate is affixed to the front of the spine using bone screws. The cervical plate helps to stabilize the neck as the bone graft stimulates healing and solid fusion.
• The incision is closed and dressed.
• This is typical of a minimally invasive surgical technique wherein muscles and soft tissues are not cut.

After ACDF surgery

You are moved from the operating room into the recovery area. Here, the nurses and medical staff closely monitor your vital signs with attention to managing post-operative pain. You should expect some discomfort. You may have pain at the incision site, occasional neck muscle spasms, or other symptoms. When you wake up, you may be wearing a cervical brace.

Post-operative care for ACDF

Your surgery is over, but now your recovery starts! If you do not understand your post-surgical instructions or a problem develops, please call us—we are here to help you.

Conventional post-spine surgery instructions

• Schedule your post-operative appointment (call 281.446.3876).
• Wear your brace as instructed.
• Keep your incision dry and clean.
• You may shower, but keep your incision covered and dry.
• Rest; you will fatigue easily while your body heals.
• Do not take a tub bath, go swimming, or sit in a hot tub or pool.
• Begin physical therapy and/or exercise as instructed.
• Take medications as prescribed.
• Do not lift or carry anything heavier than a shoe.
• Walking is encouraged.
• Do not drive until cleared by your neurosurgeon.
• Avoid riding in a car; short distances are permitted.
• Do not smoke or use tobacco.
• Eat well, your body needs nutritious food to heal.

Call your neurosurgeon's office (281) 446-3876

• Fever 101 degrees Fahrenheit or higher.
• Redness and/or swelling around the incision site expands.
• Change in the amount, odor or appearance of the incision drainage.
• Incision pain increases.
• Bowel or bladder dysfunction develops.
• Genital area numbness develops.

Talk with your neurosurgeon

We hope this information about anterior cervical discectomy and fusion has answered your immediate questions. Remember, your neurosurgeon is your most valuable source to answer your questions about symptoms, treatment and your healthcare.

You can also learn more about ACDF from the following sources:

• Anterior cervical discectomy and fusion on Wikipedia
• ACDF from the Mayfield Clinic
• Anterior Cervical Discectomy and Fusion (ACDF) Video