Anterior cervical discectomy and fusion (ACDF) is a spinal fusion surgery in the neck, or cervical, spine. The surgeon makes an incision in the front of the neck. The contents of the neck are gently retracted, enabling the front part of the spine to be seen. Fluoroscopy is used to determine the correct level(s) before the disc material is removed and the fusion graft is inserted. A surgical plate is then screwed in place over the fusion level.
Conditions Treated with Cervical Fusion
Anterior Cervical Fusion is performed for the treatment of herniated disc, painful disc degeneration, radicular syndrome, spondylosis, stenosis and myelopathy.
What to Expect Before Cervical Fusion
Once you have decided to have cervical fusion surgery, the following events take place:
- A medical examination.
- Chest X-ray, EKG and blood work.
- You may be asked to have a neurological or psychological examination.
- If taking aspirin or anti-inflammatory medications daily, stop these medications at least one week before cervical fusion surgery.
- If you take prescription medications or other drugs, including herbals, ask your doctor how soon before cervical fusion surgery you should stop taking these.
- Do not have anything to eat or drink for 6 to 8 hours before surgery.
- You will check into the hospital the morning of surgery.
- Prior to surgery, you will be asked to sign permits for surgery, anesthesia, blood and blood products.
What to Expect During Cervical Fusion
- The surgeon makes an incision in the front part of the neck.
- Fluoroscopy (live X-ray) is used to determine the correct level(s) to be operated.
- The contents of the neck are gently retracted to the side so that the spine can be seen.
- Disc tissue is removed.
- A fusion cage or wedge of bone is placed in the disc space.
- Often, a plate is screwed over the operating segment to hold the graft in place and stabilize the area.
- Surgery takes approximately 1-2 hours.
What to Expect After Cervical Fusion
- You will be in the recovery room from 1 to 1½ hours.
- The surgeon will contact your family while you are in recovery.
- After going to a hospital room, you will be able to use a PCA pump to get medication for pain control. This machine controls the amount of medication that can be received.
- Staff will usually get you out of bed shortly after surgery.
- The hospital stay is usually 1-2 days.
- A brace or collar is prescribed to restrict bending and promote healing of the fused area.
- Most patients will have some difficulty with swallowing after surgery. This generally improves with time.
- You will be given any needed prescriptions and discharge instructions.
- A set of exercises that you can do at home will be provided.
- You will be able to ride in a car or plane upon leaving the hospital.
- It is important to avoid turning your head and bending your neck excessively.
- Physical therapy is usually initiated after the first office visit with your doctor following cervical fusion surgery.
Recovery from ACF
Recovery from Anterior Cervical Fusion (ACF) varies greatly among patients and is dependent on the extent of the surgery as well as the age and health of the individual. Return to work also varies greatly among patients and is related to overall health and the type of work you do. The type of collar used may limit your ability to drive safely for a period of time.
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