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.