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Anterior Cervical Discectomy and Fusion (ACDF) Surgery in New Jersey
Patients in northern New Jersey looking for a diagnosis and treatment of spinal pain can turn to the neurosurgeons at Centers for Neurosurgery, Spine & Orthopedics (CNSO). The team of spine specialists and orthopedic spine doctors treats a broad spectrum of brain, spine, nerve, oncologic, musculoskeletal, and cosmetic conditions, along with the associated pain and deconditioning.
Featuring the latest medical technology and a comprehensive, patient-centered care model, CNSO has the resources to perform multiple types of procedures, including anterior cervical discectomy and fusion (ACDF) surgery. Learn more about ACDF procedures and the spine surgery options available to patients.
What Is an Anterior Cervical Discectomy and Fusion?
An anterior cervical discectomy and fusion (ACDF) is a surgery to remove a herniated disc or degenerative disc in the neck. ACDF surgery may be an option if physical therapy or medications fail to relieve neck or arm pain caused by pinched nerves. The procedure often is performed as outpatient surgery, meaning patients typically go home the same day.
ACDF surgery works to relieve pressure placed on compressed or pinched nerves. Healthy discs act as flexible cushions between the bones in the spine, allowing the neck to bend and rotate. Normal wear and tear on discs can cause herniation or thinning, which can pinch the nerves in the neck.
The “discectomy” part of ACDF refers to the removal of one or more discs. A discectomy can be performed anywhere along the spine. The neurosurgeon accesses the damaged disc from the front (or anterior) of the spine through the neck, gently moving the neck muscles to the side while operating to solve the problematic disc and related spine structures. This anterior approach minimizes discomfort and expedites recovery. Highly qualified surgeons can reach the disc without disturbing the spinal cord and spinal nerves.
Depending on a patient’s particular level of severity of disc disease, surgeons may need to remove one disc (single-level) seldom more than one level (multi-level). The space where the diseased disc or discs were removed is then filled with a biomechanical artificial disc or a biomechanical cage secured into place along with a bone graft. The graft serves as a bridge between the vertebrae to create a spinal fusion through the stimulation of osteocytes to produce a natural bone construct.
Following ACDF surgery, the body begins its natural healing process, and new bone cells grow around the graft. After three to six months, the bone graft should join the two vertebrae and form one solid piece of bone.
Who Are Candidates for ACDF Surgery?
Patients with a damaged cervical disc may only need or partial discectomy but if the damage is extensive, either a total discectomy or Anterior Cervical Discectomy and Fusion (ACDF) may be necessary. Only a spine surgeon trained in either neurosurgery or orthopedic spine surgery can make this determination. Potential candidates for ACDF surgery may have the following symptoms:
- Significant weakness in the hand or arm
- Arm pain that is worse than neck pain
- Symptoms that have not improved with physical therapy or medication
Patients with the following medical diagnoses, after failing conservative treatment, would benefit from ACDF surgery:
Herniated Disc
A herniated disc is the rubbery center of the disc that can bulge or rupture through a weak area in the wall of the spine. Pain and swelling occur when this material presses on a nerve.
Degenerative Disc Disease
Degenerative disc disease happens when the discs dry and shrink with age. As the disc thins, the vertebrae bones rub and pinch the nerves. These changes can lead to axial back pain with radiculopathy, disc herniation, bone spurs, or spondylosis.
Cervical Stenosis Myelopathy
Narrowing of the spinal canal, called Spinal stenosis can occur at any level of the spine. Cervical stenosis is when the spinal canal narrows within the cervical spine or neck. Bulging discs, enlarged facet joints, and thickened ligaments cause cervical stenosis. Cervical, thoracic, or lumbar stenosis can cause pain, and weakness of the arms or legs along with balance and difficulty walking problems progressing to paralysis or quadriplegia, all of which are symptoms of spinal cord compression.
After a CNSO doctor evaluates a patient with any of the above symptoms or conditions, a neurosurgeon, orthopedic spine surgeon, or pain management doctor should determine the next course of treatment. At CNSO all providers recommend care based on medical guidelines and evidence-based medicine.
Recovery After ACDF Surgery
Immediately following an anterior cervical discectomy and fusion surgery, patients must follow some restrictions for at least two weeks after the procedure. Restrictions include:
- Bending or twisting the neck
- Lifting any object heavier than five pounds
- Strenuous activity, including yard work, housework, and physical intimacy
- Smoking or using nicotine products, including vapes, dip, and chew, because the tobacco prevents new bone growth which is necessary to prevent fusion failure
- Driving, until after the one-week follow-up appointment with the spine surgeon
- Alcohol consumption in the immediate postoperative period because it thins the blood and increases the risk of bleeding
- Soaking the incision in a bath or pool
- Applying lotion or ointment on the incision
The surgeon also will provide the patient with information on how to care for their incision. Each patient should follow their doctor’s directions tailored to their personal surgical incision:
- If Dermabond skin glue covers the incision, the patient may shower the day after surgery. Gently wash the area with soap and water every day. Do not rub or pick at the glue. Pat dry.
- If staples, steri-strips, or stitches were used, the patient may shower two days after surgery. Gently wash the area with soap and water every day. Pat dry.
- If there is drainage, cover the incision with a dry gauze dressing. If drainage soaks through two or more dressings in one day, call the office at CNSO.
- Ice the incision for the first few days to reduce pain and swelling.
- Walk for five to ten minutes a few times a day, gradually increasing the time.
- Dress in clean clothes after each shower. Sleep with clean bed linens. There should be no pets in the bed until the incision heals.
- Some clear, pinkish drainage from the incision is normal. Watch for spreading redness, colored drainage, and separation.
- Staples, steri-strips, and stitches will be removed at a follow-up appointment.
While recovery lasts about four to six weeks, a post-surgical appointment with the spine specialist will happen within two weeks after surgery. The patient’s surgeon may opt for X-rays to verify that fusion is occurring and all hardware is in place. During the follow-up visit, the surgeon will determine when the patient can be released back to work and when to resume normal activity.
Alternatives to Anterior Cervical Discectomy and Fusion
Not every patient with damaged discs experiences discomfort and those who do may improve with conservative care, avoiding the need for surgery. Every patient should attempt conservative treatment early and before symptoms become too severe. Only in the event that the conservative treatment fails, or the symptoms are too severe and may cause paralysis, should a patient consider ACDF surgery as a treatment solution. Prior to surgery, the non-surgical treatment options for disc-related spine conditions include:
Physical Therapy
Physical therapy is a hands-on pain treatment focusing on increasing strength, mobility, and flexibility. It typically is seen as a first step in pain management. Physical therapy is the ideal non-surgical option for patients suffering from a spine condition.
Medications
In some cases, medications treat spine and back pain before going the surgical route. Types of medications used to treat spine and neck pain include:
- Over-the-counter medications
- Nerve relaxing medications which are also anti-seizure medications and anti-depressant medications
- Course of steroids for one week
- Opioids
The type of medication a spine specialist recommends can depend on the patient’s age, pain location, and severity. Spine specialists also will look at a patient’s history with medication and whether they have allergies before prescribing medication.
Injections
The CNSO spine surgeon or pain management doctor may suggest patients try localized steroid injections as a form of pain relief before undergoing surgery. Types of injections include:
- Epidural steroid injections: Targets a specific level of the neck or spine from where the pain radiates with steroids, helping to reduce inflammation of the spinal cord or nerve roots bilaterally.
- Transforaminal injections: These deliver a small amount of steroid medication to a precise branching nerve location in the back or spine.
- Trigger point injections: These help patients find relief from muscle spasms.
- Joint injections: These help patients manage and decrease pain. Joint injections also can be used post-surgery.
Because all patients and their pain are unique, the medical provider will determine which options treat their spine condition best. In some cases, spine specialists may use both surgical and non-surgical treatments to optimize the patient’s comfort, conditioning, strength, and rate of recovery. For example, anterior cervical discectomy and fusion surgery may be performed with pre-conditioning then post-conditioning physical therapy and pain medications and injections to minimize the need for pain medication while the surgical site heals.
Find ACDF Surgery at Centers for Neurosurgery, Spine & Orthopedics
The dedicated surgical and non-surgical team at Centers for Neurosurgery, Spine & Orthopedics understands how neck and back problems impact daily life. Patients will receive comprehensive and coordinated care to resume a healthy, less painful lifestyle that is free from disability. This is achieved by working with CNSO’s leading, board-certified neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists.
CNSO offers multiple convenient locations across northern New Jersey. As the only comprehensive spine care facility in the area dedicated to diagnosing, treating, and alleviating neck and back pain, patients can rely on CNSO for spinal care. Contact the spine specialists at CNSO today to learn more about effectively treating disc pain.
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In order to provide an accurate diagnosis with the most effective treatment option for “back problems” and brain tumors, CNSO is led by neurosurgeons and orthopedic spine surgeons. Under the care of our award-winning neurosurgeons and orthopedic spine surgeons, Northern NJ patients can have the confidence that their medical condition will be handled with consideration for their comfort and long-term well-being as well as technical excellence.
