The bones (vertebrae) of the cervical (neck) spine protect the upper portion of the spinal cord and support the head. Around these are nerve roots with sensory and motor functions that branch out of the spinal cord and extend to the arms and the hands. The cervical vertebrae (neck bones) are separated from each other by tough tissues called intervertebral discs, which act as cushions to prevent them from rubbing against each other during neck motion.
Some people experience pain in their neck as well as pain and numbness in their arms and hands when one or more of their intervertebral discs herniate or bulge out. This results in compression of the spinal cord or the nerve roots, which causes their symptoms. If these symptoms are not relieved by medications or physical therapy, surgery may be required. To relieve the pressure on their nerves, a surgical procedure called anterior cervical discectomy with fusion (ACDF) is performed.
What is Anterior Cervical Discectomy with Fusion?
Anterior cervical discectomy with fusion is a procedure that aims to reduce pressure on the involved nerves or spinal cord. The incision is made in front (anterior) of the neck (cervical spine), followed by the removal of the intervertebral disc (discectomy) to relieve the compression. When accomplished, a bone graft is placed between adjacent vertebrae to encourage bone growth and stabilize the neck (fusion). A metal plate may also be implanted in front of your cervical spine to increase stability immediately after the operation.
You may be asked to wear a neck collar during recovery for support and to limit movement while the neck bones heal or fuse. The surgeon may also recommend neck exercises and physical therapy when your neck heals. Recovery time usually lasts from 4 to 6 weeks. You may be able to gradually return to your normal daily activities, but during the first few days, you may need some help. Short distance walking is encouraged, but you may not be allowed to drive for a few weeks after surgery. Your surgeon will advise you on when you can go back to work. To verify fusion of bones, X-rays may be taken after several weeks.
ACDF is effective in relieving pain in the arm in most patients. However, numbness and weakness may persist for some time (up to several weeks). It also relieves neck pain in more than 80% of patients, but recurrence of neck pain is common. To avoid recurring neck pain, patients must practice good posture and proper lifting technique, maintain a healthy body weight, exercise regularly, observe ergonomic work conditions, learn to relax, and quit smoking.
Complications of ACDF Surgery
Potential risks and complications from ACDF include:
- Spinal Cord damage
- Nerve root damage
- Damage to the esophagus or trachea
- Inadequate relief of symptoms
- Failure of bone fusion
- Persistent speech disturbance
- Problems in swallowing
- Temporary hoarseness
- Problems with the metal screws and plates
- Need for second operation
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