An anterior cervical discectomy and fusion (ACDF) is a common, minimally invasive, operation performed on the neck to relieve symptoms from a cervical disc herniation or from cervical spine arthritis.
An anterior cervical discectomy is carried out under general anaesthetic so patients are unconscious throughout the procedure. To minimise incision length and reduce complications, Dr Laban determines the precise location of the herniated disc using image intensifier X-ray guidance. A right horizontal incision of a few centimetres is then made in the front (anterior) of the neck. The neck structures are gently moved to one side to reveal the front of the spinal bone (vertebra) and disc.
Under microscope guidance, tiny instruments are used to carefully remove the disc herniation (discectomy) and associated arthritic bone to decompress the spinal cord and nerve/s. The herniated disc is replaced with an individually selected prosthetic cage (made from PEEK and titanium and containing bone-like material to optimise integration). The cage is secured in place with small low-profile screws. The bones above and below this cage graft then slowly fuse together over the following months.
The skin is closed with absorbable sutures so there is no need to have sutures removed at a later date.
Post Procedure
Depending on the complexity of the operation and your level of mobility before the operation, you will be able to leave hospital one or two days after the procedure. Most people are able to walk unassisted, climb stairs and safely partake in light activities the day after surgery. In general, Dr Laban advises no driving for two weeks (and until you can safely perform an emergency stop and are no longer taking strong painkillers). You should carry no more than 5 kg for the first 6 weeks and no more than 10 kg from 6 – 12 weeks following the operation. Return to activities should be graded (stepwise) with the above caveats.
The wound should be kept clean and dry for one to two weeks until it is well healed.
Risks
Complications are uncommon or rare but, like all surgery, an ACDF carries risk. These risks include general risks of surgery such as infection, abnormal scarring or bleeding, venous thromboembolism (a blood clot in a vein, usually in the leg which in rare cases can dislodge and travel to the lungs), cardiorespiratory complications and general anaesthetic risks; speech or swallowing difficulties; leak of the spinal fluid (CSF leak) which surrounds the nerves; rare complications such as spinal nerve or cord injury resulting in pain, numbness, weakness, paralysis, incontinence or sexual dysfunction, stroke and death; pre-operative symptoms remaining the same, increasing or recurring; hardware failure or misplacement; non-union; instability or adjacent segment disease; and the possible need for further procedures.
Herniated Disc Surgeon
Dr Laban is a specialist Sydney spine surgeon who sees patients with all types of neck pain and back pain related problems and conditions. If your neck pain and related symptoms are getting in the way of life and not resolving themselves then it is important to get an expert opinion. Contact us today to book your appointment with Dr Laban.