What you need to know about:

Anterior Cervical Discectomy and Fusion (ACDF)

Fast Fact

80%

Worth It Rating

Average Cost:

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Recovery Period:

Several weeks

Permanence:

Over 10 years

177

Doctors

Time it takes:

1-2 hours

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Anesthetize:

General Anesthesia

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Overview of

Anterior Cervical Discectomy and Fusion (ACDF)

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Anterior cervical discectomy and fusion (ACDF) is a procedure which allows the herniated disc and degenerative structures to be removed and followed by the fusion procedure in order to stabilize the cervical vertebrae.

Goals of

Anterior Cervical Discectomy and Fusion (ACDF)

This procedure is used to relieve nerve root and/or spinal cord pressure and to alleviate symptoms caused by nerve compression.

Price of

Anterior Cervical Discectomy and Fusion (ACDF)

Average Cost

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Price Range

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Pros and cons of

Anterior Cervical Discectomy and Fusion (ACDF)

Pros

-Minimal pain from surgery because there is no muscle damage during the surgery. Quick recovery time Gold standard procedure for cervical vertebrae diseases Lower cost compared to artificial cervical disc replacement surgery.

Cons

Associated risks and complications - risks from any surgery can be reduced by following the surgeon's instructions before and after the neck surgery.

How it works:

Anterior Cervical Discectomy and Fusion (ACDF)

Anterior cervical discectomy and fusion procedure is performed under general anesthesia. The incision is around 3-cm long. The surgeon approaches the degenerated disc from the front (anterior) of the spine through the space between neck muscles. The disc material is then removed and the pain is relieved as the pressure is removed from the pinched nerve root. A bone graft, which acts as a bridge to allow a new bone to grow, is then inserted into the disc space. The surgeon then closes the incision, which usually just leaves a small scar. In some cases, the surgeon may insert screws to stabilize the spine while the treated area heals and fusion occurs.

Preparation before

Anterior Cervical Discectomy and Fusion (ACDF)

Pre - treatment

Stop taking all non-steroidal anti-inflammatory medicines (ibuprofen, Advil, etc.) and blood thinners (Coumadin, aspirin, Plavix, etc.) 7 days before surgery. Stop using nicotine and drinking alcohol 1 week before and 2 weeks after surgery to avoid bleeding and healing problems. You may be asked to wash your skin with Hibiclens (CHG) or Dial soap before surgery. It kills bacteria and reduces surgical site infections. (Avoid getting CHG in eyes, ears, nose or genital areas.) Stop smoking The most important thing you can do to ensure a successful spine surgery is quit using tobacco. This includes cigarettes, vaping, cigars, pipes, chew, and snuff/dip. Nicotine prevents bone growth and decreases successful fusion. Smoking risk is serious: fusion fails in 40% of smokers compared with 8% of non-smokers [1]. Smoking also decreases blood circulation, resulting in slower wound healing and an increased risk of infection. Talk with your doctor about ways to help you quit: nicotine replacements, medications (Chantix or Zyban), and counseling programs. Morning of surgery: Don't eat or drink after midnight before surgery (unless the hospital tells you otherwise). You may take permitted medicines with a small sip of water. Shower using antibacterial soap. Dress in freshly washed, loose-fitting clothing. Wear flat-heeled shoes with closed backs. Remove make-up, hairpins, contacts, body piercings, nail polish, etc. Leave all valuables and jewelry at home. Bring a list of medications with dosages and the times of day usually taken. Bring a list of allergies to medication or foods.

Recovery after

Anterior Cervical Discectomy and Fusion (ACDF)

Post - treatment

Recovery time generally lasts 4 to 6 weeks. X-rays may be taken after several weeks to verify that fusion is occurring. The surgeon will decide when to release you back to work at your follow-up visit. Avoid bending or twisting your neck. Don't lift anything heavier than 5 pounds. No strenuous activity including yard work, housework, and sex. DON'T SMOKE or use nicotine products: vape, dip, chew. It prevents new bone growth and may cause your fusion to fail. Don't drive until after your follow-up visit. Don't drink alcohol. It thins the blood and increases the risk of bleeding. Also, don’t mix alcohol with pain medicines. Activity: If you were given a brace, wear it at all times except when sleeping, showering, or icing. Ice your incision 3-4 times per day for 15-20 minutes to reduce pain and swelling. Get up and walk 5-10 minutes every 3-4 hours. Gradually increase walking, as you are able.

Risks & side effects

Complications in neck surgery such as this are infrequent and usually minor. However, as with any spine surgery, there are risks, including the possibility of: Adjacent vertebrae degeneration due to extra stress and load by fusion of spine segment Swallowing difficulty and temporary hoarseness Failure of bone graft healing to create a fusion General complications of any surgery including bleeding, infection, blood clots and reaction to anesthesia

FAQs:

Anterior Cervical Discectomy and Fusion (ACDF)

What is recovery like after surgery?

Patients will be up walking around within the first day after surgery and throughout the early post-operative period. If surgery is being done for arm pain due to nerve root compression, this pain is usually significantly improved shortly after surgery. If weakness or numbness was present prior to surgery these symptoms may take longer to recover. In some cases, it may not fully recover. If surgery is being done for symptoms of spinal cord compression (myelopathy), neurologic function is not always fully recovered and may take several months to improve.

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What are my restrictions after surgery?

Patients have restrictions after anterior cervical discectomy fusion surgery to ensure that the soft tissues can heal and so the bone graft fusion eventually heals appropriately as well. Usually, lifting is limited to no more than 5kg for the first two weeks. Neck range of motion will be limited by a brace that is frequently prescribed in the post-operative period from surgery. Patients are encouraged to walk around as tolerated for exercise however. If you are undergoing an anterior cervical discectomy and fusion surgery, details regarding your post-operative restrictions would be discussed in greater detail in clinic.

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Do I have to wear a collar after surgery?

Most patients may wear a soft collar for comfort after surgery. Most of the time neck collars are not mandatory as long patients follow their surgical restrictions after surgery. Harder collars are usually not expected unless there are other factors or a more complex neck surgery.

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How is the pain after surgery?

Please keep in mind that pain is a very subjective experience and one’s reaction to surgery is affected by a variety of factors as mentioned above. The most common concerns after an ACDF surgery are a sore throat (similar to after a tonsillectomy) and discomfort around their scapula (or shoulder blade). Both of these tend to resolve prior to the first post-operative appointment, 2-3 weeks after surgery. It is not uncommon for a patient to experience “reminder” symptoms after surgery. These symptoms are often described as feeling similar to the patient’s preoperative symptoms.

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