Anterior cervical decompression and fusion, also known as ACDF, is generally performed to treat a herniated disc in the neck or spinal stenosis. This can lead to a pinched nerve or a compressed spinal cord. Symptoms may include pain, weakness, numbness, tingling, balance trouble, or difficulty walking among others. When ACDF neurosurgery is required, an anterior approach is may be selected.
Anterior Cervical Decompression & Fusion
The technique of anterior cervical decompression involves making an incision in the front of the neck. The incision is horizontal when possible, and may be in a preexisting skin crease. This helps improve the cosmetic appearance. Dissection is then preformed between the trachea and esophagus on one side and the carotid artery on the other side to the front of the spine. The spinal disc is actually located in front of the spinal cord, so it is often more safely reached from an anterior approach rather than a posterior approach.
After the disc is exposed, an x-ray is taken to confirm the correct level is identified. Using a microscope, the neurosurgeon then removes the disc with specialized tools, including knife, biting instruments, and surgical drills. The ligament behind the disc, in front of the spinal cord, is also often removed during cervical spine surgery. Bone spurs may be shaved off during anterior cervical decompression and fusion.
After the nerves are fully unpinched during anterior cervical spine surgery, a bone graft is placed in the space where the disc used to be. This graft will heal in place, giving long-term stability. A titanium plate is then often placed and locked in position using bone screws. The wound is then closed, usually using absorbable sutures that do not need to be removed later.
Most patients notice rapid improvement of their arm pain after anterior cervical decompression and fusion, although symptoms such as numbness and gait difficulty may take longer to recover. Most patients go home the day after their cervical spine surgery. Despite having a spinal fusion, most patients actually have the ability to move their necks better after ACDF surgery than before, due to release of pinched nerves and treatment of the painful joints.
In some cases, a patient may be a candidate for an artificial disc replacement. This technology is new and is only appropriate for selected patients meeting specific criteria. Your neurosurgeon at the Texas Spine & Neurosurgery Center will discuss your condition with you at the time of your consultation and inform you if anterior cervical spine surgery is appropriate at all. If ACDF surgery is appropriate, he will discuss with you what type of surgery may be most appropriate. Click here to learn more about ACDF success rate and cervical spine surgery.