Overview and Indications
Anterior cervical discectomy and fusion (ACDF) is performed for patients with a symptomatic, painful herniated disc in the neck. Anterior cervical discectomy and fusion is the most common neck surgery performed by spine surgeons. It is performed to remove a portion of the intervertebral disc, the herniated or protruding portion that is compressing the spinal cord and nerve root. However, in order to do so generally involves removing nearly the entire disc, which must be replaced with a piece of bone graft and mended (fused) together to maintain stability.
Most patients are able to go home 1-2 days after surgery. Before patients go home, physical therapists and occupational therapists work with patients and instruct them on proper techniques of getting in and out of bed and walking independently. Patients are instructed to avoid bending and twisting of the neck in the early postoperative period (first 2-4 weeks). Patients can gradually begin to bend and twist their neck after 2-4 weeks as the pain subsides and the neck and back muscles get stronger. Patients are also instructed to avoid heavy lifting in the early postoperative period (first 2-4 weeks).
Most patients are placed in either a soft cervical collar or padded, plastic neck brace. This reduces the stress on the neck area and helps decrease pain. It can also be used to improve bone healing by maintaining the neck in a rigid position, especially in the first few weeks and months after surgery.
Results and Outcome Studies
The results of anterior cervical discectomy and fusion surgery in the treatment of a painful, cervical herniated disc are generally excellent. Numerous research studies in medical journals demonstrate greater than 88-97% good or excellent results from anterior cervical discectomy and fusion surgery. The fusion rate is significantly improved with the use of a small titanium plate, and typically obviates the need for extensive use of a neck brace postoperatively. Most patients are noted to have a rapid improvement of their pain and return to normal function following surgery.