What is a Anterior Cervical Discectomy and Fusion (ACDF)This procedure is used to relieve pressure on the spinal cord or spinal nerves. This procedure is performed by removing disc material in the neck. Once the disc is removed, bone or a small spacer is placed in the disc space. This spacer is either bone or it is a small cage filled with bone. The spacer is the secured to the spine using a plate and screws This procedure is used “Cutting out the disc” is the literal translation of the word discectomy. This procedure is applicable at any point between the neck and lower back in the spine. When this procedure is being used on the discs in between the cervical vertebrae, the procedure is called an Anterior Cervical Discectomy & Fusion. The term anterior means’ front’, and ‘cervical’ refers to the vertebrae of the neck, referring to the route taken by the physician to replace the disc. An incision will be made in the front of your neck, and the esophagus, trachea, and neck muscles being gently moved aside to get access to the treatment point. By using this route, interaction with the nerves and muscles of the spine are interacted with as little as possible. In certain cases, you may discover you need to have multiple discs removed using ACDF.What Are The Different Types of Graft Available?Once the damaged disc has been removed, it will be time to fill the open space with a graft that will help fuse the neighboring vertebrae together. There are multiple types of graft, defined by the source from which they’re taken. The healing process will generally take about six months, though it can happen in as little as three.The most common forms of graft are:
- Autograft Bone – When the material for the graft is taken from the patients living bone, it’s known as an autograft. Bone shavings taken from the top of the hipbone, the iliac crest, contain proteins and living bone cells to speed the healing process.
- Allograft Bone-In some cases, it’s not possible to take the material from the patient, and so bone from a cadaver will have to be used. This graft contains no living cells or proteins, and so must have them supplied by living bone from your spine.
- Bone Graft Substitute – When neither of the above two options is possible, artificial sources may be used. These are typically plastic, ceramic, or bioresorbable compounds. Bioresorbable means that they can be absorbed by the body. Much like the allograft, living bone must be provided to make healing possible.
When is a ACDF Necessary?This procedure is one of many options for patients who are suffering from cervical spinal stenosis. Cervical spinal stenosis symptoms include:
- Weakness in the arms and hands
- Tingling sensations in the neck, shoulder, arms, or hands
- Numbness in the arms
- Pain in the neck, shoulders, arms, hands
- Problems with balance and coordination
- Problems with bladder and bowel function
What Is Recovery From ACDF Like?This is usually an overnight stay in the hospital. There is no bed rest after surgery, you are encouraged to walk after the operation. A collar will be provided for support, but can be removed for eating and bathing/showering. You will typically be able to return to work after a period of 4-6 weeks, depending on the type of work you do. People who work in administrative type roles or who work at a desk can start working from home as early as 2 weeks. For patients who are involved in more labor intensive work environments, the time off from work will be greater. Return to work is largely dependent on the healing process. There are follow up visits with Dr. Zahir at 2 weeks, 6 weeks, 12 weeks, 6 months, and 1 year. Each person’s condition is unique, Dr. Zahir will customize a recovery process plan for you depending on your goals and work requirements.