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Anterior Cervical Discectomy and Fusion (ACDF) Surgery in New Jersey

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Patients in northern New Jersey seeking a diagnosis and treatment for back pain can turn to the neurosurgeons and orthopedic spine surgeons, or pain control doctors at CNSO. The team of specialists treats a broad spectrum of spine, nerve, and bone-related conditions including brain tumors, reconstructive oncologic care, musculoskeletal care, spine, hand, plastics, and cosmetic care, along with any source of pain.

Using a comprehensive, patient-centered care model, CNSO has the latest technology to perform both minimally invasive procedures as well as complex, multilevel spine surgery, including anterior cervical discectomy and fusion (ACDF) surgery. Learn more about when an ACDF is indicated as well as other spine surgery or non-surgery options available proven to treat patients.

What Is an Anterior Cervical Discectomy and Fusion?

An anterior cervical discectomy and fusion (ACDF) surgery may be an option if physical therapy or medications fail to relieve neck or arm pain caused by pinched nerves or compression on the spinal cord by a bone or a slipped spinal disc. An ACDF is a type of spine surgery in which a herniated disc or degenerative disc in the neck is removed from causing pressure on neuronal structures. The surgery is often performed as an outpatient surgery, allowing the patient to go home the same day.

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. ACDF surgery relieves pressure off compressed or pinched nerves by accessing the herniated disc from the front or anterior side of the patient.

The “discectomy” part of ACDF refers to the removal of one or more discs. A discectomy can be performed anywhere along the spine. For diseased discs within the neck, the anterior access to the spine is less invasive than accessing the discs posteriorly.

Depending on the extent of the patient’s symptoms, a surgeon may need to remove only a partial part of a disc, one whole disc (single-level), or a combination at more than one level of the spine which is referred to as a multi-level spine surgery. If the entire disc requires removal, the space between the vertebrae will then need to be filled by either an artificial disc or a bone graft along with a cage to maintain height and allow spine movement. The graft serves as a bridge between the adjacent vertebrae and allows for a cohesive vertebral spine fusion. Until the bone graft establishes itself as the new spinal support structure, the adjacent vertebrae are secured into place with titanium plates and screws.

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 damaged discs in their spinal cords who need relief may be interested in ACDF surgery. Candidates for ACDF surgery include those with:

  • 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

Additionally, patients with the following conditions can 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 spinal stenosis, bone spurs, or disc herniation.

Cervical Stenosis Myelopathy

Cervical stenosis is when the spinal canal narrows where the spinal cord passes. Bulging discs, enlarged facet joints, and thickened ligaments cause cervical stenosis. Pain, weakness of the arms or legs, and walking problems can arise from spinal cord compression.

After a medical professional at CNSO has diagnosed a patient with any of the above conditions, the patient and neurosurgeon can discuss the best course of treatment.

Recovery After ACDF Surgery

After an anterior cervical discectomy and fusion surgery, a patient must follow some restrictions for at least two weeks. Restrictions include:

  • No bending or twisting the neck
  • No lifting any object heavier than five pounds
  • No strenuous activity, including yard work, housework, and physical intimacy
  • No smoking or using nicotine products, including vapes, dip, and chew, as it prevents new bone growth and may cause the fusion to fail
  • No driving, until after a follow-up visit with a neurosurgeon
  • No alcohol consumption, as it thins the blood and increases the risk of bleeding
  • No soaking the incision in a bath or pool
  • No applying lotion or ointment on the incision

The surgeon also will provide the patient with information on how to care for their incision, which can include:

  • 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 about two weeks after surgery. The patient’s surgeon may opt for X-rays to verify that fusion is happening efficiently. During the follow-up visit, the surgeon will determine when the patient can be released back to work and when to resume normal activity.

Prior to an Anterior Cervical Discectomy and Fusion

Not every patient with damaged discs experiences pain, with many patients not needing surgery at all. All patients should attempt physical therapy initially. If there is no pain relief or if pain relief is required in order to engage in strength and conditioning, the patient should consult with a doctor fellowship trained in pain management. Non-surgical treatments for 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 for pain management. Physical therapy often is an ideal non-surgical option for patients suffering from many spinal conditions that will help prevent the need for surgery or speed up the recovery after a surgery.

Medications

In some cases, medications relieve spine and back pain especially when used in conjunction with physical therapy so strength and conditioning can occur. Types of medications used to treat spine and neck pain include:

  • Over-the-counter medications
  • Anti-depressants
  • Anti-seizure medications
  • Opioids

The type of medication a spine specialist recommends will depend on the patient’s age, type of pain, pain location, and severity. Spine specialists also consider a patient’s history with medication and whether they have allergies before prescribing medication.

Injections

The medical team at CNSO may suggest patients utilize the CNSO pain management doctors for steroid injections or other injections or forms of pain relief in order to avoid surgery. Types of injections include:

Because all patients and their pain are unique, the medical provider will determine which options treat their spine condition best. In most cases, spine specialists are able to improve a patient’s spine condition without surgery or with a combination of each. For example, physical therapy may occur first for presurgical conditioning and then again after the anterior cervical discectomy and fusion surgery along with medications and injections before and after to minimize or completely eliminate any discomfort.

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, 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.

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