Anterior cervical discectomy and fusion (ACDF) is a surgical procedure to treat nerve root or spinal cord compression by decompressing the spinal cord and nerve roots of the cervical spine in order to stabilize the corresponding vertebrae. This procedure is used when other non-surgical treatments have failed.
Anterior cervical discectomy
The nucleus pulposus (the jelly-like center of the disc) of the herniated disc bulges out through the annulus (surrounding wall) and presses on the nerve root next to it. This nerve root becomes inflamed and causes serious pain. The problem can also be caused by degenerative disc disease (spondylosis). The disc consists of about 80 % water. When one grows older, the disc starts to dry out and shrink, causing small tears in the annulus and inflammation of the nerve root.
The neurosurgeon or orthopedic surgeon enters the space between two discs through a small incision in front (= anterior) of and at the right or left side of the neck. The disc is completely removed, as well as arthritic bone spurs. The disc material, pressing on the spinal nerve or spinal cord, is then completely removed. The intervertebral foramen, the bone channel through which the spinal nerve runs, is then enlarged with a drill giving the nerve more room to exit the spinal canal.
To prevent the vertebrae from collapsing and to increase stability, the open space is often filled with bone graft, taken from the pelvis or cadaveric bone. The slow process of the bone graft joining the vertebrae together is called “fusion”. Sometimes a titanium plate is screwed on the vertebrae or screws are used between the vertebrae to increase stability during fusion, especially when there is more than one disc involved.
The surgery requires a short stay in the clinic (1 to 3 days) and a gradual recovery between 1 to 2 weeks.However,the technology has advanced and it can be performed by ‘Endoscopic Micro Discectomy” with the patient able to continue his normal life in two days.