Anterior Cervical Discectomy and Fusion (ACDF) and Instrumentation

ACDF Performed at ® Brain & Spine Center® of Southern California

Anterior cervical discectomy and fusion is a common procedure recommended for those with chronic, severe neck pain.

The individual bones of the spine are known as the vertebrae, and in between each vertebrae are intravertebral discs. These discs act as shock absorbers, and consist of a hard outer layer called the annulus, with an inner, softer material known as the nucleus. Neck pain can occur when compression of the vertebrae causes a disc to bulge or rupture, which can cause irritation or compression to the surrounding nerves of the spine. Degenerative disc disease, trauma, or injury can all be possible causes of bulging or herniated discs.

Symptoms of a bulging or herniated disc may include pain in your neck and/or arm, and possible weakness in the hand and/or arm.

When a bulging or herniated disc is suspected, your physician may recommend imaging (MRI, CT, myelogram) to determine the true diagnosis. Conservative treatments including medications and physical therapy may be recommended, but if symptoms do not improve with these treatments, ACDF may then be recommended.

The surgeon will explain all portions of the procedure before surgery. The discectomy portion of the surgery is to remove the damaged portion of the disc, thereby relieving the irritation and pressure that the damaged disc is placing on the spinal nerves. Once the disc has been removed, the intravertebral space is empty, which causes it to be unstable. To stabilize this area, the surgeon will perform a bone graft, which will serve to support, immobilize, and strengthen the vertebrae. The bone graft may be accompanied by metal plates and screws to further support the spine.

The source of the bone graft varies, and includes an autograft, which comes from the patient’s own hip, an allograft, which comes from a donor cadaver, or a man-made bone substitute created from medical grade ceramic, plastic, or bioresorbable compounds. If an autograft is determined to be the ideal graft, it will be performed at the same time as the ACDF. Within several months after the procedure, the grafted bone should join the above and below vertebrae to create one solid section of bone.

Anterior cervical discectomy and fusion is considered a minimally invasive procedure, and is performed under general anesthesia. The patient lies on their back for the procedure, and the surgeon will operate through a small incision in the throat area using fluoroscope, or real-time, moving x-ray. The surgeon will remove the damaged disc and any bone spurs that may be causing irritation or pressure on the spinal nerves. The graft will then be placed, and any instrumentation will also be set in place.

After the surgery, the patient may feel pain at the incision site, and at the hip if autograft is performed. The patient may need to wear a cervical collar or neck brace to stabilize the neck and aid in the healing process. Patients will receive instruction on low impact exercise to strengthen the surgical area, and physical therapy and rehabilitation is often prescribed to help regain function and range-of-motion.

The surgeon will explain the risks and benefits of the surgery to the patient, and will also give post-operative instructions to encourage the fastest and best recovery possible. To ensure the safety of all patients, ONE Brain and Spine Center surgeons use state-of-the-art technology for intricate procedures. Residents of Newport Beach and surrounding California areas can schedule a consultation for their spine condition, today!

Key Terms:
Anterior: situated at, positioned toward, or directed at the front
Cervical: the upper portion of the spine, the neck
Discectomy: removal of some or all of intravertebral disc
Fusion: procedure in which two or more of the spinal vertebrae are connected to prevent movement between them
Instrumentation: use of medical hardware to provide stability or support

ONE® Brain & Spine Center® in Southern California is the leader in innovative and comprehensive treatment and care for neurological, brain, back, neck, and spine disorders. Call (949) 383-4190 or Contact Us for appointment.