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Anterior Cervical Discectomy and Fusion (ACDF)

 

 download Dr. Aryan ACDF Surgery Information (to be reviewed by patient prior to surgery)

Pain in the neck and arms/hands, among other symptoms, may occur when an intervertebral disc herniates, i.e. when the annulus fibrosus (tough, outer ring) of the disc tears and the nucleus pulposus (soft, jelly-like center) squeezes out and places pressure on neural structures, such as nerve roots or the spinal cord. Bony outgrowths, called bone spurs or osteophytes, which form when the joints of the spine calcify, may also cause these symptoms. An anterior cervical discectomy with fusion (ACDF) is an extremely successful and common operation that involves relieving the pressure placed on nerve roots and/or the spinal cord by a herniated disc or bone spurs -- a condition referred to as nerve root compression.











Through a small incision made near the front of the neck (i.e. the anterior cervical spine) and with the use of a microscope, Dr. Aryan is able to:

  • Remove the intervertebral disc to access the compressed neural structures

  • Relieve the pressure by removing the source of the compression

  • Place a bone graft between the adjacent vertebrae, and

  • Implants a tiny metal plate to stabilize the spine while it heals, to allow for a more rapid recovery.

Discectomy involves removing all or part of an intervertebral disc. The term discectomy is derived from the Latin words discus (flat, circular object or plate) and ectomy (removal). Spinal fusion involves placing bone graft between two or more opposing vertebrae to promote bone growth between the vertebral bodies.

Why is it done?
Pressure placed on neural structures, such as nerve roots or the spinal cord, by a herniated disc or bone spur may irritate these neural structures and cause: pain in the neck and/or arms; and lack of coordination, numbness or weakness in the arms, forearms or fingers. Pressure placed on the spinal cord as it passes through the neck (cervical spine) can be serious since most the nerves for rest of the body (e.g. arms, chest, abdomen, legs) have to pass through the neck from the brain. Patients who suffer from these symptoms are potential candidates for this operation.

The Operation
An understanding of what an anterior cervical discectomy with fusion involves will help you to approach your operation and recovery with confidence.

  • Incision - The operation is performed with you lying on your back. A small incision is made to one side of the front of your neck.  Dr. Aryan makes smaller incisions and prefers to hide his incisions in existing neck creases for optimal cosmetic result. 

  • Exposure - After gently moving aside the soft tissue, Dr. Aryan exposes the disc between the vertebrae.

  • Removal - The intervertebral disc and, in some cases, a portion of the bone around the nerve roots and/or spinal cord is then removed to relieve the compressed neural structures and to give them additional space.

  • Material Placement - The graft is placed in the disc space, where it helps the adjacent vertebrae to fuse.  Dr. Aryan prefers to use a synthetic scaffold in the disc space that allows the patient's own bone (as opposed to bone from a cadaver) to fuse the space.

  • Stabilization - A tiny metal plate is implanted on the front of the cervical spine to increase the stability of the spine immediately after the operation. Dr. Aryan use these implants to decrease the amount of time that you have to wear a cervical collar after surgery and to increase your chances of developing a solid fusion.  In addition, Dr. Aryan is one of the first surgeons in the country to use bioabsorbable plates for single-level ACDF in select patients (see below). 

  • Closure - The operation is completed when Dr. Aryan closes and dresses the incision.
Recovery
Dr. Aryan will have a specific post-operative recovery/exercise plan to help you return to normal life as soon as possible. The amount of time that you have to stay in the hospital will depend on this treatment plan. You will normally be up and walking in the hospital by the end of the first day after the surgery.  In general, patients go home the morning after surgery and follow-up in the office in a couple weeks. 

cervical extension.jpg   cervical flexion.jpg example of neck motion following 1-level cervical fusion by Dr. Aryan with bioabsorbable plate

As you read this, please keep in mind that all treatment and outcome results are specific to the individual patient. Results may vary. Complications, such as infection, blood loss, and bowel or bladder problems are some of the potential adverse risks of spinal surgery. Please consult your physician for a complete list of indications, warnings, precautions, adverse events, clinical results, and other important medical information.  

Surgery for Spinal Disorders - Cervical

Surgery for Spinal Disorders
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