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HOW IS ACDF SURGERY DONE

Your surgeon and anesthesiologist will use general anesthesia to help you remain unconscious throughout the entire surgery. Talk to your doctor about the possible complications of surgery before you have acdf surgery, such as blood clots or infections.

An acdf surgery can take one to four hours depending on your condition and the number of disks to be removed.

An acdf is done with an anterior approach, which means that the surgery is done through the front of the neck as opposed to through the back of the neck. This approach has several typical advantages:

Direct access to the disc. The anterior approach allows direct visualization of the cervical discs, which are usually involved in causing the stenosis, spinal cord or nerve compression, and symptoms. Removal of the discs results in direct nerve and spinal cord decompression. The anterior approach can provide access to almost the entire cervical spine, from the c2 segment at the top of the neck down to the cervicothoracic junction, called the c7-t1 level, which is where the cervical spine joins with the upper spine (thoracic spine).

Less postoperative pain. Spine surgeons often prefer this approach because it provides access to the spine through a relatively uncomplicated pathway. The patient tends to have less incisional pain from this approach than from a posterior operation.

To perform an acdf surgery, your surgeon:

1. Makes a small cut on the front of your neck.
2. Moves your blood vessels, food pipe (esophagus), and windpipe (trachea) aside to see your vertebrae.
3. Identifies the affected vertebrae, disks, or nerves and takes x-rays of the area (if they haven’t done so already).
4. Uses tools to take out any bone spurs or disks that are damaged or pushing on your nerves and causing pain. This step is called diskectomy.
5. Takes a piece of bone from somewhere else in your neck (autograft), from a donor (allograft), or uses a synthetic compound to fill in any empty space left behind by the removed bone material. This step is called bone graft fusion.
6. Attaches a plate and screws made of titanium to the two vertebrae around the area where the disk was removed.
7. Puts your blood vessels, esophagus, and trachea back in their usual place.
8. Uses stitches to close the cut on your neck.

Not all acdf surgeries are the same—there are a number of options and variables as part of the surgery that can play a role in how successful it is and impact the relative risks and potential complications. Patients are well served to fully understand and discuss the important variables that are part of the acdf; for example, which or how many levels will be addressed and why, what type of implant will be used and why, and what type of bone graft the surgeon is recommending and why.while an acdf is the most commonly performed operation for treatment of cervical disc pathology, a newer procedure, called a cervical artificial disc replacement, is also available.

Treatments

HOW DO I PREPARE FOR ACDF SURGERY
• DURING THE WEEKS LEADING UP TO THE SURGERY:
• ATTEND ANY SCHEDULED APPOINTMENTS FOR BLOOD TESTS, X-RAYS, OR ELECTROCARDIOGRAM (ECG) TESTS.
• SIGN A CONSENT FORM AND SHARE YOUR MEDICAL HISTORY WITH YOUR DOCTOR.
• TELL YOUR DOCTOR ABOUT ANY MEDICATIONS OR DIETARY SUPPLEMENTS, HERBAL OR OTHERWISE, THAT YOU’RE CURRENTLY TAKING.
• DON’T SMOKE BEFORE THE PROCEDURE. IF POSSIBLE, TRY TO QUIT SIX MONTHS BEFORE YOUR SURGERY, AS SMOKING CAN SLOW DOWN THE HEALING PROCESS. THIS INCLUDES CIGARETTES, CIGARS, CHEWING TOBACCO, AND ELECTRONIC OR VAPOR CIGARETTES.
• DON’T DRINK ANY ALCOHOL ABOUT A WEEK BEFORE THE PROCEDURE.
• DON’T TAKE ANY NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS), SUCH AS IBUPROFEN (ADVIL), OR BLOOD THINNERS, SUCH AS WARFARIN (COUMADIN), ABOUT A WEEK BEFORE THE PROCEDURE.
• GET A FEW DAYS OFF WORK FOR THE SURGERY AND RECOVERY.
• ON THE DAY OF THE SURGERY:
• DON’T EAT OR DRINK FOR AT LEAST EIGHT HOURS BEFORE THE PROCEDURE.
• SHOWER AND DRESS IN CLEAN, LOOSE CLOTHING.
• DON’T WEAR ANY JEWELRY TO THE HOSPITAL.
• GET TO THE HOSPITAL TWO TO THREE HOURS BEFORE YOUR SURGERY IS SCHEDULED.
• MAKE SURE A FAMILY MEMBER OR CLOSE FRIEND CAN TAKE YOU HOME.
• BRING WRITTEN INSTRUCTIONS REGARDING ANY MEDICATIONS OR SUPPLEMENTS THAT YOU NEED TO TAKE AND WHEN TO TAKE THEM.
• FOLLOW YOUR DOCTOR’S INSTRUCTIONS AS TO WHETHER TO TAKE YOUR NORMAL MEDICATION. TAKE ANY NECESSARY MEDICATIONS WITH ONLY A SMALL AMOUNT OF WATER.
• PACK ANY IMPORTANT BELONGINGS IN A HOSPITAL BAG IN CASE YOU NEED TO STAY OVERNIGHT AFTER THE SURGERY.
THE SURGERY HAS 2 PARTS
Anterior cervical discectomy. The surgery is approached through the anterior, or front, of the cervical spine (neck). The disc is then removed from between two vertebral bones.

Fusion. A fusion surgery is done at the same time as the discectomy operation in order to stabilize the cervical segment. A fusion involves placing bone graft and/or implants where the disc originally was in order to provide stability and strength to the area.

While this surgery is most commonly done to treat a symptomatic cervical herniated disc, it may also be done for cervical degenerative disc disease. It is also commonly done to remove bone spurs (osteophytes) caused by arthritis and to alleviate the symptoms associated with cervical spinal stenosis.

ACDF may be done for one level, or for more than one level, of the cervical spine.

HOW IS ACDF SURGERY DONE
Your surgeon and anesthesiologist will use general anesthesia to help you remain unconscious throughout the entire surgery. Talk to your doctor about the possible complications of surgery before you have acdf surgery, such as blood clots or infections.

An acdf surgery can take one to four hours depending on your condition and the number of disks to be removed.

An acdf is done with an anterior approach, which means that the surgery is done through the front of the neck as opposed to through the back of the neck. This approach has several typical advantages:

Direct access to the disc. The anterior approach allows direct visualization of the cervical discs, which are usually involved in causing the stenosis, spinal cord or nerve compression, and symptoms. Removal of the discs results in direct nerve and spinal cord decompression. The anterior approach can provide access to almost the entire cervical spine, from the c2 segment at the top of the neck down to the cervicothoracic junction, called the c7-t1 level, which is where the cervical spine joins with the upper spine (thoracic spine).

Less postoperative pain. Spine surgeons often prefer this approach because it provides access to the spine through a relatively uncomplicated pathway. The patient tends to have less incisional pain from this approach than from a posterior operation.

To perform an acdf surgery, your surgeon:

1. Makes a small cut on the front of your neck.
2. Moves your blood vessels, food pipe (esophagus), and windpipe (trachea) aside to see your vertebrae.
3. Identifies the affected vertebrae, disks, or nerves and takes x-rays of the area (if they haven’t done so already).
4. Uses tools to take out any bone spurs or disks that are damaged or pushing on your nerves and causing pain. This step is called diskectomy.
5. Takes a piece of bone from somewhere else in your neck (autograft), from a donor (allograft), or uses a synthetic compound to fill in any empty space left behind by the removed bone material. This step is called bone graft fusion.
6. Attaches a plate and screws made of titanium to the two vertebrae around the area where the disk was removed.
7. Puts your blood vessels, esophagus, and trachea back in their usual place.
8. Uses stitches to close the cut on your neck.

Not all acdf surgeries are the same—there are a number of options and variables as part of the surgery that can play a role in how successful it is and impact the relative risks and potential complications. Patients are well served to fully understand and discuss the important variables that are part of the acdf; for example, which or how many levels will be addressed and why, what type of implant will be used and why, and what type of bone graft the surgeon is recommending and why.while an acdf is the most commonly performed operation for treatment of cervical disc pathology, a newer procedure, called a cervical artificial disc replacement, is also available.

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