Anterior Cervical Discectomy and Fusion

ACDF can treat:

1. Herniated Discs: When the inner gel-like core of a disc bulges out through a tear in the outer layer, it can compress nearby nerves or the spinal cord.
2. Degenerative Disc Disease: Wear and tear on the spinal discs can lead to pain, instability, and nerve compression (a pinched nerve).
3. Cervical Radiculopathy: Compression of the nerve roots in the cervical spine can cause pain, weakness, or numbness radiating down the arms.
4. Cervical Myelopathy: Compression of the spinal cord itself can lead to more serious symptoms, including difficulties with coordination, balance, and bowel or bladder function.
5. Cervical spine fractures: Spinal fractures can cause pain and instability in the cervical spine.
6. Spinal infections or spinal tumors can put pressure on the spinal cord and nerves.
7. Cervical arthritis: Arthritis that causes bone spurs to develop and compress the spinal nerves or the cord.

The surgery is performed through a minimally invasive incision on the front of the neck (anterior). This allows Dr. Colman to access the cervical spine without disturbing the spinal cord, muscles and nerves. Then, under microscope visualization, he performs a discectomy, where the damaged disc that is causing pain and other symptoms is removed to alleviate pressure on the spinal cord and nerves. He will also remove bone spurs, herniated disc fragments, cartilage, and calcified disc fragments.

After the disc and fragments are removed, the space between the vertebrae is re-aligned and the normal disc height re-established. This space is then filled with a bone graft or a synthetic spacer. The graft promotes bone growth, leading to the fusion of the adjacent vertebrae over time. Metal plates and screws may be used to provide stability while the fusion occurs. Bone eventually grows joining the vertebrae together. Full healing takes about 6-12 months, but patient function and activity is typically restored within the first 2-3 months.

• Pain relief: One of the primary benefits of ACDF is the significant reduction or complete elimination of neck and arm pain caused by compressed nerves. Removing the damaged disc alleviates the pressure on the spinal cord or nerve roots.
• Improved function: Patients often experience improvements in their ability to perform daily activities. The relief from pain and the stabilization of the cervical spine enhance overall functionality and quality of life.
• Neurological improvements: Resolution of neurological deficits such as numbness, weakness and tingling in the arms and hands.
• Stabilization of the Spine: The fusion process provides long-term stability to the cervical spine. This stabilization helps prevent future disc herniations or degenerative changes at the operated level.
• High Success Rate: ACDF has a high success rate of 90% to 95%. Many patients experience substantial and long-lasting relief from their symptoms. The procedure is well-established and has been refined over decades, leading to predictable and reliable outcomes.
• Minimally Invasive Approach: The anterior approach to the cervical spine allows surgeons to avoid major muscles and the spinal cord itself, leading to less postoperative pain and quicker recovery compared to posterior approaches.
• Quick Recovery Time: Most patients can return to normal activities relatively quickly, with many resuming light activities within a few weeks and full activities within a few months.

Generally, risks for anterior cervical surgery are low. Commonly cited risks include dysphagia (difficulty swallowing), dysphonia (hoarse voice), or failure to heal with bony fusion after surgery. Fortunately, these risks are either rare (<5%) or are transient, meaning they are self limited and resolve within the first 4-6 weeks.

Adjacent segment disease (breakdown of discs above or below the surgery) is thought to occur at a rate of 2-3% per year after fusion.

More serious risks such as bleeding, swelling, blood vessel injury, holes in the trachea (wind pipe) or esophagus (food pipe), spinal cord injury, persistent neck or arm pain, and medical risks of anesthesia and surgery are exceedingly rare, fortunately.