Anterior Cervical Discectomy & Fusion (ACDF) is a combined surgical procedure used to decompress spinal nerves and stabilize the cervical spine (neck).
Dr. Scheid performs ACDF surgery to relieve pain, numbness and weakness in the neck, shoulder, and arms, and to provide stability in the cervical (neck) portion of the spine.
Dr. Scheid generally recommends an ACDF to remove a damaged disc that is causing debilitating pain due to compressed nerves or when there is excessive motion between the vertebrae. This can be due to a fracture or congenital anomaly, but the majority of patients develop damage from progressive, chronic degenerative disease. Often, this occurs as a result of osteoarthritis or a herniated disc.
Dr. Scheid performs the ACDF procedure using a minimally invasive technique where he makes a small incision in the front (anterior) of the neck. This approach allows access the disc without disturbing the neck muscles and uninvolved spinal nerves.
The surgery itself is made up of two parts:
1. Discectomy – The damaged disc is removed through the small incision that was made. This eliminates pressure on the compressed nerve, thus relieving the pain and other symptoms the compression causes.
2. Fusion – A bone graft or implant device is inserted in the empty space where the damaged disc was to provide strength and stability to the area.
After the disc is removed, the space between the bony vertebrae is empty. To prevent the vertebrae from collapsing and rubbing together, a spacer bone graft is inserted to fill the open disc space. The graft serves as a bridge between the two vertebrae to create a spinal fusion. The bone graft and vertebrae are fixed in place with metal plates and screws. Following surgery, the body begins its natural healing process and new bone cells grow around the graft. After 3 to 6 months, the bone graft should join the two vertebrae and form one solid piece of bone. The instrumentation and fusion work together, similar to reinforced concrete.
After fusion you may notice some range of motion loss, but this varies according to neck mobility before surgery and the number of levels fused. If only one level is fused, you may have similar or even better range of motion than before surgery. If more than two levels are fused, you may notice limits in turning your head and looking up and down. Motion-preserving artificial disc replacements have emerged as an alternative to fusion and Dr. Scheid uses this technique whenever possible.
The majority of patients have ACDF surgery due to progressive, chronic degenerative conditions like osteoarthritis or disc herniation.
With the ACDF procedure, it takes several months for the bones to fully fuse together but most patients feel better soon after surgery.