Anterior Cervical Discectomy and Fusion is abbreviated ACDF. During this type of cervical spine (neck) surgery, an intervertebral disc is removed (discectomy) and bone graft and/or an interbody device is inserted into the open space between the upper and lower vertebral bodies. An interbody device is an implant (e.g., cage, cylinder) that gives structure and support to the newly fused vertebrae.
Surgery may include decompression. Decompression means the surgeon removes portions of bone or tissue that are exerting pressure on a nerve root or the spinal cord. Osteophytes (bone spurs), scar tissue, and thickened bone may compress nearby nerve structures.
ACDF may require spinal instrumentation to stabilize the cervical spine. The type of instrumentation used in cervical surgery usually includes plates and screws. Instrumentation provides immediate spinal stability. Bone graft can stimulate new bone growth and join the upper and lower vertebral bodies. This process is called fusion.
Most cases of cervical nerve compression and/or herniated disc resolve after a few weeks or months of nonsurgical care. If your spine surgeon recommends surgery, the procedure, possible benefits and risks, as well as the recovery process will be explained to you in detail.
You must stop tobacco use before surgery. Nicotine hinders bone growth, slows healing, increases the risk for infection, and increases your risk for a failed fusion.
Tell your doctor about all prescription and over-the-counter medications you take. In your list, include vitamins, herbal products, and other supplements. Some types of drugs and supplements, such as blood thinners and anti-inflammatory medications, must be discontinued before surgery. Your doctor will provide you with written instructions to avoid any confusion.
Your spine surgeon will give you written instructions about how to prepare for your surgery, e.g., do not have anything to eat or drink after midnight the evening before your procedure. You will also receive instructions regarding your discharge, e.g., you must make arrangements for someone to drive you home after your surgery or hospital stay. In addition, you can anticipate receiving information pertaining to activity restrictions, follow-up appointments, etc.
All medical procedures, nonsurgical or surgical, have some risk of complication. Risks associated with surgery include allergic reactions, excessive bleeding, blood clot, infection, nerve injury, paralysis, and death. The usual risks of general anesthesia apply and will be explained to you by your anesthesiologist.
Wear loose-fitting clothing and flat-heeled, slip-on shoes with closed backs to the hospital. A shirt with button front closure may facilitate dressing prior to your discharge home.
If instructed, take medication the morning of surgery with small sips of water.
After you meet recovery milestones such as the ability to walk, safely move about, urinate, eat (soft or light foods) and drink, you are discharged. You are sent home with a prescription for pain medication. Many patients find they no longer need pain medication after only a few days. Pain is then managed with acetaminophen (Tylenol).
At home instructions may include:
Some patients may experience a tingling or warm sensation in the arm on the side where surgery was performed. This can occur as the nerves heal. If symptoms worsen, please contact your spine surgeon.
Remember to keep all of your postoperative appointments and never hesitate to call your spine surgeon's office if you have questions or concerns.