It is suggested for patients who are diagnosed with a herniated or degenerative disc upon diagnostic tests like MRI or CT scan, have prominent pain and weakness in the arm or hand and have significant neck pain. It is advised only after patient has not been able to get relief from physiotherapy or medical management over a period of time. ACDF is helpful in treating both bulging & herniated disc as well as degenerative disc disease, where discs wear out, formation of bone spurs occurs and joints get inflammed.
The anterior approach in ACDF involves less muscle injury by allowing better access to the disc from front of the spine as compared to the posterior approach. It offers the surgeon an easier approach to the cervical spine and patients suffer less incisional pain.
ACDF is performed using an implant to provide support till the fusion occurs. This surgery is very regular amongst spine surgeries and has given good results to patients suffering from cervical disorders and thus limited mobility. Cervical problem is one of the most common lifestyle disorders in today's society.
The surgery is performed under general anesthesia. Once unconscious, patient's neck area is cleaned and also the hip area, if bone graft is to be taken from patient's body only ; else only neck is cleaned and prepared for incision. After that a small incision is made in the neck . The surgeon then makes an access to the spine retracting through the trachea, esophagus, and arteries. Muscles that provide support to the spine are moved aside to be able to clearly see the discs and vertebrae.
Now the removal of disc including the obtruding portion is done. This lets the spinal nerves and cord return to normal position. While removing diseased disc, the doctor also checks if the surrounding areas are disease free. The surgeon then measures the size of the empty disc and based on that bone graft is inserted into the disc space between the vertebrae. A metal plate is placed and fixed with screws to impart stability and support healing. An x ray is then taken to ensure that graft and implants are rightly positioned.
After the completion of surgery, the incision area is closed with sutures and cleaned with sterile antibiotics. There is minimal scar which doesn't even require bandage.
The surgery takes 2 to 3 hours depending upon the involved levels of spine. Patient is shifted to post op recovery area after the completion of surgery, where his/her vitals are monitored for next few hours. After that shifting to ward area is done. Patient can get discharged in 1 to 3 days depending upon the severity of surgery and recovery of patient.
During post op stay in the hospital, patient is visited by physiotherapist who instructs on proper techniques of getting in and out of bed and also sitting and walking independently. In the early post op period, patients are advised not to bend or twist their neck. They can do so once the pain has subsided and neck & back muscles have become stronger. At the time of discharge, the treating doctor gives instructions regarding medications, physical therapy, brace or corset wearing, and follow up visit.
Following care needs to be taken while recovering from surgery:
Follow up visit is done usually after 8 to 10 days of surgery. The doctor will remove sutures, inspect the surgical site and give further instructions. He may advise to continue or terminate physical therapy depending upon patient's recovery.
Approximately 92 to 100% of patients get relieved from pain after the surgery. However, weakness or numbness may persist for another few weeks to months.
No surgery is risk free and so ACDF too has some risks associated with it. The major ones include:
All the above issues can be evaded or taken care of if the patient is in the right hands. i.e., under the expert care of best doctor and healthcare facility.
Call the doctor in case of :