Anterior Cervical Discectomy and Fusion

A rupture or herniation of cervical disc or several discs may make you deal with severe pain in the neck or arm. This usually happens when the soft nucleus squeezes out by tearing the annulus of the disc. It exerts pressure on the nerve root and sends pain signals with numbness or tingling in the neck arms, shoulders, or sometimes the hands. So many factors, including age, cervical injury, wear and tear can cause cervical disc herniation. When the pain is severe and anti-inflammatory drugs do not work, your doctor may recommend a procedure called anterior cervical discectomy and fusion. Should you go for this procedure? Keep reading to learn everything about this surgical procedure.

What Is an Anterior Cervical Discectomy and Fusion?

It is the most common surgical procedure used to treat herniated or damaged cervical discs. It involves removing the ruptured disc to relieve pressure on the nerve roots. It is called anterior because your surgeon will gain access to your cervical spine through a small incision in the front of your neck. The surgeon will separate the soft tissues of the neck and remove the affected disc. Sometimes, it is fine to leave the space between the vertebrae open, but your surgeon may decide to use a bone graft to help maintain the normal height of the disc space.

A bone graft is a small piece of bone usually taken from the pelvic area or a bone bank fills the disc space and fuses the vertebrae together. The process is called fusion. It usually takes several months for your vertebrae to fuse completely.

When Do You Need the ACDF Surgery?

Your doctor may recommend anterior cervical discectomy and fusion in the following situations:

  • Your diagnostic tests show that you have a degenerative or herniated disc.
  • You have weakness in your arm and hand.
  • Your arm pain is severer than neck pain.
  • Your pain and symptoms have not improved with medication and physical therapy.

How Is the Procedure Done?

The procedure involves removing one of your affected discs and then fusing your vertebrae together. It is a complicated procedure and has the following steps.

  1. Incision: Your surgeon will start by making a small incision in the front of your neck. You will be on your back during the procedure.
  2. Removal: Your surgeon will use a retractor to pull aside fat and muscles around your neck, expose the disc between the vertebrae. Then use forceps to remove part of the disc and a surgical drill to enlarge the disc space to empty the inter-vertebral space. This gives the doctor easy access to the disc space and helps remove any bone spurs.
  3. Bone grafting: After removing any bone spurs, your surgeon will place the bone graft in the disc space.
  4. Fusion: Your surgeon fuses the vertebrae below and above the removed disc. Sometimes, a metal plate is used in place of a bone graft to provide added stability to the cervical spine.
  5. Incision closure: The final step is to close the neck incision. It is done in several layers. This may be done using dissolving suture material, but you will have to come again for removal of staples or the skin sutures, if your doctor chooses to go that way.

What Are the Risks?

Quite like all types of surgical procedures, there are certain risks of complications. You may experience pain even after your surgery, which usually calls for additional surgery. The incision may become infected when you do not take precautionary measures. It is therefore a good idea to discuss the risks associated with anterior cervical discectomy and fusion before you make a decision.

Check out the following video to learn more about the procedure of anterior cervical discectomy and fusion.

What About the Healing and Recovery Process?

It takes several months to recover from the surgery, so you have to pay attention to many things for successful recovery.

Recovery at Hospital

You need to take care of certain things soon after the completion of your surgery.

  • Pain: You usually experience pain in the incision area, but pain in the arm or neck is possible as well. This is usually due to the inflammation caused by the previously compressed nerve. Take your medication to relieve the pain.
  • Hygiene: In most cases, you are allowed to take a shower the next day of your surgery. This helps you feel better but you should leave the dressing in place to protect the incision. Ask your nurse to change the dressing afterwards.
  • Nutrition: You will need intravenous fluids during the early recovery phase. This will continue until you are in a position to take liquids without feeling nauseous. You can start eating other foods once your appetite returns. You may have to take laxatives if you experience constipation after surgery.
  • Emotional changes: It is a complicated procedure, and it is natural to feel tired and somewhat discouraged for several days after your surgery. This usually happens when your body makes hormonal changes to deal with the stress of surgery. Be sure to maintain a positive outlook to accelerate recovery.

Recovery at Home

You need to be very careful when you are discharged from the hospital because there is no one supervising you for what you can or cannot do after anterior cervical discectomy and fusion surgery. Here is what you should keep in mind:

  • Physical activity: Be sure to maintain some activity when you get home. Walking for some time will help a lot. Keep adding distance every day and walk at a slow pace to avoid severe pain and fatigue. You can also resume your sexual relations but be sure to avoid positions that put strain on your neck or cervical spine.
  • Working: Ask your doctor about how long it will take to return to work. It depends on your progress and the type of work you do.
  • Medication: You can reduce the amount of pain medication you take while recovering. A simple way is to increase the time between taking pills. You may not want to take any medication if you think discomfort in your neck and arm is manageable. Continue with massage, exercise, heat, and short rest periods to reduce inflammation and nerve sensitivity.
  • Hygiene: You do not need to cover the incision if your doctor has removed the skin sutures. You can continue to take a tub bath in early recovery phase and take a shower after a few weeks. Do not rub over your incision area while taking a bath.
  • Nutrition: Maintain a well-balanced diet and eat foods from each food group, including meats, dairy products, fruits, and vegetables. Avoid heavy foods and those high in calories in the early recovery phase.