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Anterior cervical discectomy and fusion (ACDF) is a minimally invasive spine surgery performed to remove a degenerative or herniated disc in your neck.
Symptoms of a degenerative or herniated disc in your neck include:
A herniated disc is a condition in which the gel-like material inside the disc bulges or breaks through a weakened area in the annulus, or surrounding wall. It can cause a pinched nerve.
A degenerative disc exhibits the normal wear and tear that comes with use and age. Bone spurs can form as bones rub together, and facet joints can swell. The discs can also start drying out, making the space between the vertebrae smaller and leading to compressed nerves.
If conservative management such as physical therapy and medications do not improve the problem, Dr. Khamsi may recommend ACDF.
For this surgery, Dr. Khamsi accesses the damaged disc through the throat area. He moves aside the trachea, muscles, and esophagus to expose the discs and vertebrae. The surgery allows him to reach the disc without disturbing the spinal cord or nerves.
After he removes the damaged disc, the space between the vertebrae is empty. At this point, Dr. Khamsi performs fusion to prevent the vertebrae from collapsing. Spinal fusion involves placing a spacer bone graft to fill in the empty space. The graft is held in place between the two vertebrae with metal plates and screws.
A few months after the surgery, bone cells begin to grow around the graft, joining the two vertebrae together to form one piece.
There are three types of spacers that can be used to replace the removed discs:
An autograft bone comes from your own body. Dr. Khamsi can remove a small bone block from your pelvis. This type of graft is thought to have a higher fusion rate; however, with advancements in science and technology, autograft is rarely used anymore.
An allograft bone is cadaver bone and comes from a donor. These bones come from people who agreed to donate organs after their death. Although this type of graft does not have bone-growing cells, it can often be mixed with your stem cells aspirated from the bone marrow, and it has shown to have a very high rate of fusion while avoiding the harvesting of the bone from patients' pelvis.
A bone graft substitute can be plastic, ceramic, or bioresorbable compounds. These are synthetic spacers made by different biotech companies that have been used for cervical fusion with a high rate of success.
Immediately after cervical fusion there may be some loss of range of motion; however, this improves over time and studies have shown that general cervical fusion is NOT associated with loss of range of motion of the neck.
ACDF is, depending on the number of levels, often an outpatient surgery. Most people can return home a few hours after the procedure is done. Some patients may experience difficulty swallowing or changes in voice; however, these side effects are often temporary and resolve over time.
Contact Dr. Khamsi today to learn more.
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