Anterior Cervical Discectomy and Fusion NYC

Relieving Neck and Nerve Pain with ACDF

Anterior cervical discectomy and fusion, often abbreviated ACDF, is a regularly performed procedure that treats many cervical spine (neck) disorders. An ACDF is usually performed to address a herniated disc in the neck or a degenerated disc. The most common disc-related issues are disc degeneration and herniation, both of these may compress the spinal cord that resides within the spinal canal or the spinal nerve roots.

Common symptoms treated with ACDF may include neck, shoulder, upper back, and/or arm pain. Other neurologic symptoms may include tingling, weakness and numbness in the hands or arms. The intention of an ACDF is to alleviate symptoms, decompress the nerve root(s) and spinal cord, secure the neck and, in turn, allow the patient to return to their everyday activities of daily living.

Anterior = Front

The incision can be performed in the front of the neck, either on the right or left side. In order to create a pleasing cosmetic result, the surgical incision can be done within a skin fold or a natural skin crease.

Cervical = Neck

The cervical levels are one region of the spine. There are seven vertebrae in the neck; they are abbreviated C1 (top) through C7 (bottom). The disc levels are also abbreviated. For example, referring to C3-4 refers to the intervertebral disc located between the third and fourth cervical vertebral bodies (bones).

Discectomy = To Remove The Disc

Dr. Stieber makes a small incision in the front of the neck and then meanders between the muscles in the front of the neck to reveal the unhealthy or ruptured disc.

Under microscopic magnification, the offending disc is carefully removed using a variety of specialized microsurgical instruments.

The spinal cord and nerve roots are alleviated of compression, and nerve probes as well as direct visualization are used to confirm that the neural elements are happy and free of further compression.

Fusion = To Join or Combine

Bone graft is applied into the empty space between the upper and lower vertebral bodies where the disc has been removed. A titanium or polymer spacer or cage may also be inserted into the intervertebral space in order to impart stability and reestablish the height between the vertebral bodies. In order to further stabilize the neck and to promote stability and fusion, a tiny plate with screws is applied to the front of the spine at treated level. The body’s natural healing processes then generate new bone to grow around and into the instrumentation resulting in a spinal fusion. Spine surgery is not required for every patient with a cervical degenerative disc problem or cervical disc herniation. Dr. Stieber may recommend an anterior cervical discectomy and fusion for the following reasons: if progressive worsening of neurologic symptoms occurs or non-operative treatment fails to relieve the pain, spinal instability, and/or neurological problems. Some examples of neurologic dysfunction are numbness, loss of function, and weakness.

About Cervical Discectomy

ACDF is performed under general anesthesia. The neck is prepared for surgery by being thoroughly cleaned, after this, an incision is made on the left or right side of the neck. To expose the disc the tissues and muscles are gently and carefully pulled aside. Dr. Stieber uses a type of real-time x-ray during surgery, this is called fluoroscopy. Various specially-designed surgical instruments are used to remove the ruptured or herniated disc. The vertebral bodies are gently separated and the original height is restored between the vertebrae. The disc herniation and bone spurs (osteophytes) that are compressing or pinching the spinal nerve roots are carefully removed. Bone graft fills the space after discectomy.

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Types of Bone Graft

Local Autograft is used, when possible, by recycling the bone that is removed from the ends of vertebral bodies during the normal process after discectomy when the bony endplates of the vertebra are smoothed and flattened.
Iliac Crest Autograft is the patient’s own bone; it is normally taken from the hip through a tiny incision.
Allograft is donor bone from a bone bank.
Bone graft substitute; there are different types, some of which are synthetic (man-made) and available in different shapes.

After Surgery

The patient is moved into the recovery area after the surgery. Our nurses and other members of the medical team closely monitor the patient’s vital signs, this would include the patient’s respiration, pulse, blood pressure, and level of pain.

There is some post-operative pain that should be expected and patients will receive pain medication either through their IV (intravenous line) or by mouth. Dr. Stieber provides ACDF patients with instructions about what to expect and self-care after hospital discharge.

Pre and post operative x-rays of a 49 year old female who was treated with an ACDF

Pre and post operative x-rays of a 49 year old female who was treated with an ACDF

This information includes information about ways to manage any pain, medications, bathing and incision care, activity restrictions, and surgical follow-up appointments. As always, Dr. Stieber and his staff welcome questions and ensure that all patient concerns are thoroughly addressed.

A post-operative cervical brace may be prescribed to wear for a period of time after surgery to help immobilize and support the neck while healing.
Most patients have this performed as an outpatient procedure and go home on the same day as surgery. Dr. Stieber will go over the likelihood of hospitalization with patients before their surgery date.

NYC Anterior Cervical Discectomy and Fusion