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During an Anterior Cervical Discectomy and Fusion (ACDF) surgery, a cervical herniated or degenerative disc is removed through an incision in the front of the neck, after which the adjacent bones are fused together with the help of a graft.

The goals of ACDF surgery are eliminating the symptoms caused spinal cord and nerve root pressure when physical therapy and medications have proven unable to lead to a desired outcome. The success rate of ACDF surgery is very good — up to 92 percent of all patients find relief from the pain, numbness, tingling and weakness they experienced prior to their operation.

Anterior Cervical Discectomy and Fusion isn’t necessarily a magic bullet though, and complications can occur.

Possible Complications Of Anterior Cervical Discectomy And Fusion Surgery

The vast majority of patients undergoing ACDF surgery come away from their operation without any complications, while one or two in every 100 patients will experience more severe complications. ACDF carries the same risks that any surgery carried out under general anesthesia does, as well as the risk of complications specifically related to the procedure.

These include such surprising complications as erectile dysfunction, a droopy eye, and incontinence, as well as incision-related complications like a hoarse voice and swallowing difficulties. After your surgery, the levels adjacent to the removed disc will be placed under some additional stress, making degeneration of those levels a possible complication as well.

Then, there is the possibility of paralysis, your symptoms worsening, nerve damage, a malpositioned implant, a cerebrospinal fluid leak, or even in exceedingly rare cases the surgery being performed on the wrong disc. Failure to fuse is another possibility. This again is rare, though more common in smokers. Note that in failure to fuse cases, or in case where the outcome of the operation was jeopardized by injury, a repeat anterior decompression surgery, with the use of bone grafts from the patient themselves, has a high chance of leading to good outcomes.

Preventing Complications — And When To Alert Your Medical Team

As a patient, you can play an active role in your recovery, thereby doing your part towards preventing complications, by following your surgeon’s instructions to the letter. After ACDF surgery, these instructions will notably include:

  • Not smoking for at least 12 months after the procedure, as doing so would greatly increase your risk of complications including the dreaded failure to fuse.

  • Refraining from taking anti-inflammatory medications, which likewise increase your risk of failure to fuse.

  • Wearing a neck brace where advised, and paying close attention to any advised limitations of physical activity and movement. Do not engage in the lifting of heavy objects or in vigorous physical activity.

Immediately let your medical team know if, following your ACDF surgery, you find yourself in worse pain than before the operation, if you experience leg or arm numbness, if signs of infection are present at the incision site or fluid is oozing from it, if you run a fever, or walking is difficult or you can’t seem to find your balance.

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