Anterior Cervical Discectomy

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Anterior Cervical Discectomy and fusion is a surgical procedure to remove a herniated or degenerative disc from the spine in the neck and fuse adjacent vertebral bone. This procedure helps to alleviate corresponding pain, weakness, numbness, and tingling.

Advantages of Anterior Cervical Discectomy Surgery

Direct access to the disc- the anterior approach allows direct visualization of the cervical discs and hence Removal of the discs is easier in this approach.
Less postoperative pain- this anterior surgical approach is preferred by the surgeon as it provides a convenient way to directly approach the cervical discs. The patient experiences less pain due to the small incision and less muscular dissection as compared to the posterior approach.

Procedure of Anterior Cervical Discectomy Surgery

This surgical procedure is done under general anesthesia. The anterior cervical discectomy surgeon first makes an incision in front of the neck and moves aside the soft tissues to reach the front of the spine. The surgeon then removes the damaged discs or any bone spurs that puts pressure on the spinal cord or nerve roots. This phase of the procedure is done with an operating microscope with microsurgical and neurosurgical techniques.
The anterior cervical discectomy surgeon then performs either a spinal fusion or fixation. An arthroplasty can also be performed in which the disc is replaced by an artificial cervical disc. This procedure is called Total disc arthroplasty. To perform a spinal fusion, the surgeon replaces the disc with a bone graft taken from the patient’s body or from a bone bank. Then, a titanium plate is screwed to put the bones in place ensuring stability. Once the bones get fused, the spine stabilizes.
The patients are usually discharged in a day or two from the hospital. Follow-up x-ray is usually scheduled for the next 8-12 weeks.

Risks of Anterior Cervical Discectomy Surgery

  • No satisfactory pain relief after the surgery
  • Temporary swallowing difficulty (dysphagia) which usually improves in a week time.
  • Failure of a bone healing leading to non-fusion or pseudoarthrosis
  • A spinal fluid leak or Dural tear
  • Damage to nerve root
  • Damage to the spinal cord
  • Bleeding due to blood vessel injury
  • Infection
  • Damage to trachea/ esophagus
  • Hematoma leading to airway compromise
After 1-2 weeks, the doctor advises physical therapy which helps to reduce pain and can restore complete mobility to the area. For some people, the healing process goes well but some suffer from chronic stiffness. An active lifestyle with exercises aids in proper healing and fast recovery.

If you have been advised to undergo an anterior cervical discectomy, consult a Neurosurgeon for a second opinion.  

Frequently Asked Questions

ACDF is a surgery that removes a damaged cervical disc through a small incision at the front of the neck and fuses the adjacent vertebrae to stabilize the spine. It is recommended for cervical disc herniation or cervical spondylosis causing persistent neck and arm pain, numbness, weakness, or spinal cord compression unresponsive to conservative treatment.

Hospital stay after ACDF is typically 1–2 days. Most patients can return to desk work within 2–4 weeks. A cervical collar is worn for 4–6 weeks to support healing. Heavy lifting and physical labor require 3–6 months before return. Fusion is confirmed on X-ray at 3–6 months post-operatively.

ACDF is generally safe with excellent outcomes. A long-term consideration is adjacent segment diseaseincreased stress on discs above and below the fused level that may cause degeneration over decades. Cervical disc replacement (arthroplasty) is an alternative that preserves motion and may reduce this risk in appropriate patients.