Anterior Cervical Discectomy and Fusion (ACDF)

Degenerative Disease

The term degenerative disease refers to the loss of normal tissue structure and function as a result of the aging process. Degenerative disease may also result in pain. Degenerative disease involves the intervertebral disc, the vertebral body, and/or the facet joint. There are many types of degenerative disease including herniated disc, radiculopathy, facet joint pathologies, cervical spondylotic myelopathy, and osteophytes (also known as bone spurs).

Herniated Disc

A herniated disc is when the nucleus of the intervertebral disc pushes out from the center of the disc. It may place pressure on the spinal cord or nerve root causing symptoms.

Symptoms may include:

• Neck pain

• Arm pain – radiculopathy (compression of the nerve root)

• Myelopathy (compression of the spinal cord)

Cervical Radiculopathy

Radiculopathy is when a spinal nerve root is irritated and/or compressed by either a herniated disc, osteophyte (bone spur), or both.

Symptoms of radiculopathy may include:

• Pain in extremities

• Tingling in extremities

• Numbness in extremities

• Muscle weakness

• Reflex loss

• Neuropraxia – temporary loss of function

Procedural solutions include decompression of the nerve root through:

• Anterior cervical discectomy

• Anterior cervical discectomy and fusion

• Anterior cervical discectomy and artificial disc replacement

• Posterior cervical foraminotomy

ACDF

ACDF is a cervical spine fusion procedure done from the front of the neck where the diseased disc are removed with the goal of eliminating painful motion at the treated levels. In an ACDF, unhealthy discs are removed, and the empty disc spaces are filled with spacers made of either bone or a medical grade plastic cade, like PEEK, which is indicated for use in interbody fusion at one level or two contiguous levels between the C2-3 and C7-T1 discs. Before insertion, the cages are packed with bone grafting material to aid in interbody fusion. The graft material may be comprised of cancellous and/or corticocancellous bone.

Once inserted, the cages require supplemental fixation with a device like anterior cervical plate. Plates are designed to serve as a brace while bone fusion occurs inside the disc space. When used together, the PEEK cage and the anterior cervical plate can be used only to treat cervical disc disease at one or two contiguous levels between the C2-T1 disc spaces, and patients should have failed at least six weeks of non-operative treatment before undergoing surgery.

Risks

Risks of ACDF surgery include, but not limited to:

• Tissue or nerve damage caused by improper positioning and place of implants or instruments.

• Fracture, microfracture, resorption, damage, or penetration of any spinal bone and/or bone graft or bone graft harvest site at, above, and/or below the level of surgery.

These therapies are not for everyone. Please consult dr. Aji. A prescription is required.