Anterior Cervical Discectomy and Fusion (ACDF)
What is ACDF?
Anterior cervical discectomy and fusion (ACDF) is a minimally invasive procedure that stabilizes the spine, corrects cervical disease, and relieves symptoms. The procedure provides relief by removing damaged intervertebral discs and by preventing motion around spinal vertebrae that are involved in spinal stenosis, disc degeneration, pinched nerves, and disc herniations. The procedure is considered minimally invasive because the surgery is completed through a small incision and by pushing aside muscle tissue rather than by opening the entire back and cutting through muscle tissue as in traditional back surgery.
Symptoms of cervical spine disease can manifest as localized and/or radiating symptoms. Localized symptoms include neck pain, neck stiffness, decreased range of motion, and cracking sounds in the neck with motion. Headaches are also common; they usually start in the neck and radiate up to the back of the head, but can radiate to the front of the head as well. Radiating symptoms typically occur unilaterally (on one side of the body), but can occur on both sides and will generally follow the nerves in the neck, branching into the shoulders, arms, and hands. Radiating pain can be described as sharp, shooting, throbbing, electrical, burning, numbness, or tingling and there may be weakness with specific muscle actions.
Cervical Disc Herniation: Intervertebral discs provide shock absorption in the spine and are made of a fibrous outer ring, the annulus fibrosis, surrounding a jelly-like inner section, the nucleus pulposus. As repetitive tasks and aging create wear on the annulus fibrosis, small tears create weak spots in the disc and the nucleus pulposus squeezes through, creating a herniated disc and potentially compressing the spinal cord and/or nerve roots.
Cervical Spinal Stenosis: Spinal stenosis is narrowing of the spine around neural elements, like the spinal cord and nerve roots. Narrowing may occur from a variety of causes, including disc herniation or arthritis. Arthritis and aging can cause intervertebral discs to shrink, narrowing the space through which nerves branch out from the spine; they can initiate bone spur formation, which are bony growths meant to prevent movement at a joint, but can compress a nerve; and they can cause ligaments to grow, which can also compress a nerve.
Cervical Pinched Nerves: Pinched nerves include the spinal nerve roots that are being compressed because of diseases, such as disc herniation or spinal stenosis.
Cervical Facet Joint Syndrome: The facet joints connect spinal vertebrae, enabling motion in the spine while also preventing extreme motions. As wear accumulates, the surrounding cartilage begins to thin and the lubricating synovial fluid runs low, allowing bone on bone grinding. To prevent motion at these areas of friction, the spine starts forming bone spurs, or bony growths, that may press on a nerve directly or cause inflammation of the joint.
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