Anterior Cervical Discectomy and Fusion (ACDF)
Anterior cervical discectomy and fusion, also known as ACDF, is generally performed in patients who presents with neck pain, arm pain, numbness of arm and hand ,upper extremity weakness, and tingling caused by various problems in the neck. The surgery is aimed at restoring nerve function in the neck to encourage improvement of strength, relief of pain and possible reduction of numbness.
Dr. Jebraili generally recommends cervical surgery to treat either spinal cord/nerve impingement or spinal instability. Decompression surgery and spinal fusion surgery are the two procedures used to treat these conditions. This operation is generally performed through the front of the neck (anterior approach) however there are conditions that require an approach through the back side of the neck (posterior approach.)
Am I A Candidate For Cervical Surgery?
Patients who are candidates for cervical surgery typically experience some or all of the following symptoms: neck pain, shooting pain down the arms or between shoulder blades, numbness, and tingling of the hand and arms, weakness of the upper extremity. In rare cases patients may experience difficulty with their balance and performing fine manual tasks. Common conditions that might necessitate surgical intervention would be cervical stenosis (narrowing of the spinal canal) due to herniated disks or bone spurs in the neck or misalignment of the spinal vertebrae in the neck.
The initial management of many of these conditions may include nonoperative measures including use of anti-inflammatory medications (NSAIDs) , muscle relaxants, activity modification, chiropractic care and physical therapy, interventional pain management through injections and alternative medicine including biofeedback and relaxation techniques, yoga and acupuncture. If the problem is more serious or does not lend itself to nonoperative measures based on your radiographic and clinical presentation, Dr. Jebraili may recommend spine surgery as the appropriate treatment.
What Should I Expect During The Treatment?
Your surgeon has the option of approaching your cervical spine from the back (posterior technique) or from the front (anterior technique) of your neck.
In most cases, surgeons opt for an anterior approach because it generally allows for maintaining proper alignment of the spine, less incisional pain and earlier postoperative rehabilitation and mobility.
Additionally, Dr. Jebraili will use surgical loupes or the operative microscope to provide optimal magnification and proper illumination during the surgery. The incision is typically less than 2 inches although it might vary depending on the number of levels involved. Dr. Jebraili encourages early mobility as much as possible including visit a of surgery. Patients receive postoperative antibiotics and painkillers. However, this operation is not very painful compared to other reconstructive spine surgery because of the limited amount of muscle dissection. Some patients experience pain in the throat from anesthesia intubation and surgery in the surrounding area. Voice rest, use of cough drops and soft food and liquids through for the first few days are recommended to minimize postoperative discomfort.
Do I Need To Follow Any Special Instructions Following My Treatment?
The majority of patients do not require any rigid bracing such as a cervical collar. Factors that may affect a patient’s outcome include their presenting neurological condition, duration of symptoms, severity of the radiology, age and other medical risk factors , type of employment and level of activity required postoperatively.
Dr. Jebraili will monitor your healing postoperative through followup evaluation as needed and x-rays over the course of your healing to ensure that your spine is properly healing. Some patients will also undergo postoperative physical therapy generally beginning about 2-3 weeks after their operation. Dr. Jebraili utilities an individualized post operative care plan consisting of some or all of the following: pain relievers, muscle relaxants, bracing, icing machine and postoperative physical therapy.