Anterior Cervical Discectomy & Fusion
What is Anterior Cervical Discectomy & Fusion?
Anterior Cervical Discectomy and Fusion (ACDF) is a standard surgical procedure used to remove a herniated or degenerated disc from the cervical (neck) area of the spine. ACDF is the most commonly used procedure for this type of condition and usually provides excellent results.
When ACDF is performed, Dr. Lipani opens the front (anterior) of the neck area (cervical) so as not to disturb the spine, spinal cord, or strong muscles in the back of the neck, and removes one or more discs from the spine (discectomy). Dr. Lipani then fills the area with a bone graft (fusion), which may be held in place by metal plates and screws. When the body begins its natural healing process after surgery, new bone cells will grow around the bone graft, creating a single piece of bone to join the vertebrae above and below the discectomy. If metal plates and screws have been used, bone may grow around these and reinforce them.
Some symptoms that may indicate that a patient is a candidate for ACDF are significant numbness or weakness in limbs, especially hands and arms, and significant arm pain which may be accompanied by neck pain. Patients will first have diagnostic tests, such as MRI, CT scan, and/or myelogram to determine the presence of a herniated or degenerative disc. Even after a diagnosis is made, patients will still discuss non-surgical options with their orthopedic surgeon before proceeding. Non-surgical treatments can be highly successful in diminishing the symptoms of herniated discs, and may even heal herniated discs after a few months.
Prior to electing to have ACDF, Dr. Lipani and the patient will also discuss different types of bone grafts, including grafts from the patient’s own bone (autograft), grafts from donor bone (allograft), and bone grafts from man-made materials.
Preparing for Surgery
The most important thing a patient can do to ensure a successful ACDF surgery is to cease all tobacco use. Nicotine inhibits bone growth, which prevents the body from creating bone cells to fuse the graft and the vertebrae, and decreases blood circulation, which slows healing and increases infection risk. Failed fusion, in which the bone graft does not successfully fuse the two vertebrae, is five times more likely for smokers than non-smokers. If you smoke, please talk to your doctor about the many ways available to help you quit.
Dr. Lipani will give you more information about how to prepare for your surgery, including showering beforehand and wearing clean clothes, not wearing jewelry or makeup, wearing practical footwear, taking your regular medications, and bringing a list of all your medications (including all prescription, non-prescription, and herbal supplements that you take) and allergies with you.
After giving the patient anesthesia and preparing the hip area if an autograft will be used, Dr. Lipani makes a small incision at the front of the throat area either to the left or right of direct center and moves the esophagus, trachea, and muscle tissue to the side to expose the vertebrae and discs. Dr. Lipani then uses a fluoroscope to help find the problem vertebra and disc. He uses a spreader to gently separate the discs above and below the disc to be removed, cuts the wall of the disc, and then uses special grasping tools to remove most of the disc. Finally, he uses a microscope to help pull out remaining pieces of the disc. Ligament running behind the vertebrae is removed so that any remaining disc material or bone spurs pressing on the spinal nerves can be removed.
After the disc is removed, Dr. Lipani uses a drill to prepare a space in the vertebrae above and below the removed disc, so that they can better hold the material for the bone graft and expose the graft to the inner cells of the vertebrae, which contain blood cells and proteins necessary for bone growth. He places the bone graft or man-made bone graft material into the space and may secure it place with screws and a plate.
Finally, Dr. Lipani removes the spreaders and closes the muscles and skin at the incision with sutures. He then places sterile bandaging and/or biologic glue across the incision.
After surgery, patients are taken to a recovery area where their vitals and pain level are assessed. Most ACDF patients are able to go home the same day, and are prescribed pain medication for a limited time period. Full recovery takes four to six weeks.
Schedule a Consultation
If you suffer from a herniated disk, anterior cervical discectomy & fusion may be the right treatment for you. Call our New Jersey office at 609-890-3400 to schedule a consultation with Dr. John Lipani.