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ACDF may be helpful in treating these conditions:
Bulging and herniated disc: The gel-like material
within the disc can bulge or rupture through a weak area
in the surrounding wall (annulus). Irritation and swelling
occurs when this material squeezes out and painfully
presses on a nerve.
Degenerative disc disease: As discs naturally wear out,
bone spurs form and the facet joints inflame. The discs
dry out and shrink, losing their flexibility and cushioning
properties. The disc spaces get smaller. These changes
lead to foraminal or central stenosis or a disc herniation
Let’s define the term
Anterior Cervical Discectomy and
Fusion (ACDF)
one word at a time.
Anterior
means the
front, because the procedure is performed in the front
of the neck. This allows Dr. Pazmiño a means of stay-
ing away from the spinal cord and nerves posteriorly.
Cervical
means neck, as this is a surgery for neck pain.
Discectomy
literally means “cutting out the disc.” In this
case we are removing the disc herniation and bone spurs
in front of the cervical spine or neck. Discectomy means
the surgery involves removing the damaged disc, this
leaves a gap or space where the disc once was.
Bone Graft PEEK Cage Carbon Fiber
Spacer Spacer Spacer
After the disc is removed, the space between
the bony vertebrae is empty. To prevent the ver-
tebrae from collapsing and rubbing together, Dr.
Pazmiño fills the open disc space with a bone
graft or spacer, see 3 photos above. The graft
serves as a bridge or spacer between the two
vertebral bodies. To make sure the bone graft or
spacers stay in place afterwards they are immo-
bilized with a thin metal plate and small 12 mm
screws. Immediately following surgery the body
begins its natural healing process and new bone
cells form through the center of the spacer. After
3 months this new bone starts to get sticky. By
12 months, the bone graft completely joins the
vertebral blocks above and below to form one
solid piece of bone, this is called a fusion.
In the Xray and the image below you can see what this
procedure looks like. The disc has been removed and
in its place a spacer, in this example a spacer made of
a material called PEEK, has been placed in between the
bones. This spacer is held in place by thin plate and small
screws.
What are the results?
Anterior cervical discectomy is successful in relieving
Arm pain in 92 to 100% of patients. However, arm weak-
ness and numbness may persist for weeks to months.
Neck pain is relieved in 73 to 83% of patients. Achieving
a spinal fusion varies depending on the technique used
and your general health (smoker).
What are my instructions after surgery?
After surgery, pain is managed with narcotic medica-
tion for a limited period (2 to 4 weeks). Hoarseness,
sore throat, or difficulty swallowing may occur in some
patients and should not be cause for alarm. These symp-
toms usually resolve in 1 to 4 weeks. After a fusion, do
not use non-steroidal anti-inflammatory drugs (NSAIDs)
(e.g., aspirin; ibuprofen, Advil, Motrin, Nuprin; naproxen
sodium, Aleve) for 6 months after surgery. NSAIDs may
cause bleeding and interfere with bone healing. Do not
smoke. Smoking delays healing by increasing the risk of
complications (e.g., infection) and inhibits the bones’
ability to fuse. Do not lift anything heavier than 5 pounds
(e.g., gallon of milk). Dr. Pazmiño requests all patients
gradually return to your normal activities. Walking is
encouraged; start with a short distance and gradually
increase to 1 to 2 miles daily. A physical therapy program
may be recommended by Dr. Pazmiño. You may shower
immediately after surgery. No tub baths, hot tubs, or
swimming pools for three weeks. Follow Dr. Pazmiño’s
specific instructions. Call for your follow up appointment
in Dr. Pazmiño’ office which will be 2-3 weeks after sur-
gery. For further information feel free to look us up online
at
www. spinecal .com
Normal
Normal Disc Herniation
Back / Posterior
Front of neck / Anterior