Procedure

Anterior Cervical Discectomy & Fusion (ACDF)

If you experience neck pain that’s associated with tingling and numbness in your one or both arms, there’s a good chance you have a pinched nerve in the top of your spine. Untreated, the pain only worsens. Early intervention by New Jersey’s top spine specialists at Premier Brain & Spine can often correct the damage with conservative treatments. But if that doesn’t work, top spine surgeons perform an anterior cervical discectomy and fusion to alleviate your pain and return you to full mobility. Call the nearest location for an appointment – in Hackensack, Paterson, Edison, Union, Rutherford, Freehold, Bayonne, West Orange, or West Caldwell, NJ or in Goshen, New York.

What Is Anterior Cervical Discectomy and Fusion?

Anterior cervical discectomy and fusion, commonly referred to as ACDF, is a surgical procedure  performed on your spine to remove one or more damaged discs. The two vertebrae are then fused together with a bone graft. ACDF is done on the cervical portion of your spine, accessing the top vertebra through the outside of your throat, which is easier and less traumatic, compared to entering from the back or posterior.

ACDF is one of the most common neck pain procedures, performed to alleviate spinal cord compressions that contribute to pain and weakness in your neck, shoulders and arms. New Jersey’s top spine specialists at Premier Brain & Spine  have extensive experience in this minimally invasive procedure. Following a thorough exam and appropriate imaging tests, these expert spine center doctors determine if ACDF is an appropriate procedure to alleviate your neck pain.

When spinal discs in your back become compressed, they press on the nerves running through them, which causes pain. Common symptoms that may require anterior cervical discectomy and fusion include:

  • Arm pain that’s more severe than the pain in your neck
  • Weakness in your hands and arms that gets progressively worse the longer the pinched nerve goes untreated
  • Numbness and tingling sensations in your arms and hands, on one or both sides
  • Worsening pain and ongoing weakness for more than three months, even after conservative measures, such as medication and physical therapy

The outpatient procedure performed in one of the New Jersey orthopedics spine care centers usually is done to alleviate the physical pain and limitations caused by a pinched nerve from conditions such as:

Since reaching the damaged disc from the front of your neck doesn’t require moving the spinal cord, nerves or muscles, complications are minimized. When you rely on the expertise of spine experts at these NJ spine centers, your recovery goes much smoother too. After receiving anesthesia, the four main steps that occur during the ACDF procedure include:

  1. Incision. Your NJ spine center doctor makes a horizontal incision approximately one to two inches long on either side of your neck. If more than one disc is being removed, the incision may be made vertically for easier access. The surgeon carefully moves aside anterior neck muscles and ligaments, the trachea and the esophagus to gain direct access to the compromised disc.
  2. Excision. The disc is located with the use of fluoroscopy, a live feed of x-rays that reveals the compromised disc. Your doctor removes the disc in its entirety. If a pinched nerve is involved, then a foraminotomy may be performed.
  3. Replacement. Without the disc, there’s a gap to be filled. Left as is, the vertebrae above and below collapse onto each other. A graft is inserted here to replace the removed disc.
  4. Fusion. Once the graft is in place, a metal plate is drilled in to support and stabilize the area. This allows the bones to grow together. On average, it takes 12 to 18 months for the fusion to complete and the graft to solidify.

Your spinal doctor chooses between three options for the graft:

  1. Autograft. The graft comes from bone cells collected from your iliac crest, which is your hip bone. This bone has natural bone-growing components that makes it an ideal selection to encourage bone cell growth in place of the removed disc. The graft removal occurs during the ACDF.
  2. Allograft. This graft originates from a cadaver as an organ donation. Unlike the autograft, there’s no bone-growing components in allografts. Despite that, the allograft is ready to use and doesn’t require an excision from your hip bone. Before being inserted, the allograft is filled in with living bone shavings collected from your spine during the ACDF.

Graft substitute. Graft substitutes are man-made, created from plastic, ceramic and other materials considered bioresorbable. They’re often referred to as cages. Like allografts, these cages are filled in with living bone shavings taken from your spine. Prior to the procedure, ensure that this option is available and if your health insurance covers it.

Pain doesn’t dissipate immediately after an ACDF, and you don’t get back full feeling in your arms and hands right away. On average, it takes between four to six weeks. Your spine surgery center team provides you with guidance regarding your recovery, which includes:

  • Dealing with pain. You may take prescription painkillers during the first week, then after that switch to non-narcotic pain medications. Expect the pain to be in your shoulder and back instead of your neck due to the fusion changing the muscles’ biomechanics. Commonly, the pain from the graft incision on your hip may be worse than the neck incision. Appropriate pain management may become the primary goal in your recovery.
  • Swallowing. Because of the close proximity of the surgery to your throat, you may experience some difficulty swallowing. You’re advised to stay on a liquid diet for a day or two. Eventually, you can include soft food.
  • Speaking. You may have some trouble speaking for a few days or weeks after surgery. You may only manage to whisper.
  • Feeling depressed or anxious. Dealing with recovery challenges and managing pain can be difficult. Tell your doctor during follow-up visits if you need mental health assistance.
  • Having regular bowel movements. Constipation is common and can stem from using pain medications and the lack of fiber and exercise.

Other key points in your recovery deal with mobility and moving your neck. In addition to following your prescribed medication schedule, closely follow your doctor’s instructions, which may include:

  • Resuming normal routine activities of daily living with precaution within the first week
  • Avoiding excessive neck motions
  • Wearing a prescribed neck brace

Because of their extensive experience and top-rated facilities, your advanced spine surgery center doctors provide exceptional care and follow-up after any procedure. For a thorough evaluation of your cervical neck pain or any other issue affecting your back, contact the nearest Premier Brain & Spine location today.