Your spine (backbone) is a column of individual vertebral bones that are separated by cartilaginous discs and are held together by muscles, ligaments, and tendons. The spinal cord and spinal nerves, which control movement and sensation, are protected by the spine. The upper part of your spine is your cervical spine, which is located in your neck.

An ACDF is a sophisticated spine procedure that may involve all of these structures. It is performed by a spine surgeon, who can be either an orthopedic or a spine surgeon.

While an incision in the front of the neck (anterior approach) is common for ACDF, it may not be possible if you have a structural issue in that area that would interfere with surgery. If your healthcare provider believes that you would benefit from cervical discectomy and fusion, you may have the surgery done from the back of your neck.

Risks

Spine surgery and anesthesia carry inherent risks. An ACDF is a major surgical procedure that can result in serious physical impairment if any of the structures involved are damaged.

Persistence or worsening of symptoms, mild weakness or sensory disturbance in one or both arms and/or legs, difficulty swallowing food or water, impaired speech, paralysis of one or both arms and/or legs, loss of bowel or bladder control, and death are all risks of ACDF surgery.

While complications are possible, the risk of post-operative problems is low. Surgery is usually successful, resulting in a reduction in symptoms.

Purpose of ACDF

An ACDF is performed to relieve cervical radiculopathy, which is pressure on a spinal nerve in the neck. Disc herniation can occur as a result of degeneration, trauma, or disease of a vertebral disc, and it can cause impingement on the spine or spinal nerves.

A disc that is impinging on these structures may require removal because it is usually irreparable. Symptoms can appear suddenly or gradually over time.

A shorter duration of symptoms and severe pre-operative weakness and/or pain are associated with greater post-operative improvement than mild weakness or chronic symptoms.

However, it's important to understand that pain in the neck and arms caused by cervical radiculopathy may not improve with any type of surgery, including ACDF.

How to Prepare

ACDF surgery outcomes can vary, and treatment plans must be tailored to each individual case. Based on your symptoms, the duration of your condition, and the anatomical issues revealed by your imaging studies, you and your healthcare provider will discuss the likelihood of improvement.

Make sure you have enough time to recover before deciding whether or not to have your ACDF procedure, which will include several days of rest, several weeks or months of limited activity in your neck and arms, and months of physical therapy.

Prior to surgery, you will undergo a thorough physical examination and diagnostic tests to determine the location and structure of your spine problem. You can also discuss the size and location of the surgical scar with your doctor.

Pre-operative testing is also required for general anesthesia planning. As part of your pre-operative testing, you will have an electrocardiogram (EKG), a chest X-ray, and blood tests, including a complete blood count (CBC) and blood chemistry levels.

Recovery

ACDF surgery recovery takes six to eight weeks. Your recovery time will vary depending on your overall health, the severity of your cervical spine disease, and the extent of your surgery.

You will have several follow-up appointments with your spine surgeon, and neck imaging studies to assess your healing, suture removal, and physical therapy throughout your recovery.

Bathing instructions and how to keep your incision clean and dry will vary depending on the type of sutures and wound dressing you have.

You will be able to take pain medications as prescribed, but you must avoid pain medications that may cause bleeding or interfere with healing, such as over-the-counter anti-inflammatories.

Because narcotic pain medications can cause constipation, your medical team will give you instructions on how to manage this side effect with medications or dietary changes if you will be using this type of pain control.