Anterior cervical discectomy and fusion
Encyclopedia
Anterior cervical discectomy
and fusion (ACDF) is a surgical procedure to treat nerve root or spinal cord compression by decompressing the spinal cord
and nerve roots of the cervical spine in order to stabilize the corresponding vertebrae. This procedure is used when other non-surgical treatments have failed.
The nucleus pulposus
(the jelly-like center of the disc) of the hernia
ted disc bulges out through the annulus
(surrounding wall) and presses on the nerve root next to it. This nerve root becomes inflamed and causes serious pain. The problem can also be caused by degenerative disc disease (spondylosis
). The disc consists of about 80 % water. When one grows older, the disc starts to dry out and shrink, causing small tears in the annulus and inflammation of the nerve root.
The neurosurgeon or orthopedic surgeon enters the space between two discs through a small incision in front (= anterior) of and at the right or left side of the neck. The disc is completely removed, as well as arthritic
bone spurs. The disc material, pressing on the spinal nerve or spinal cord, is then completely removed. The intervertebral foramen, the bone channel through which the spinal nerve runs, is then enlarged with a drill giving the nerve more room to exit the spinal canal.
To prevent the vertebrae from collapsing and to increase stability, the open space is often filled with bone graft, taken from the pelvis
or cadaveric bone. The slow process of the bone graft joining the vertebrae together is called "fusion". Sometimes a titanium
plate is screwed on the vertebrae or screws are used between the vertebrae to increase stability during fusion, especially when there is more than one disc involved.
The surgery requires a short stay in the clinic (1 to 3 days) and a gradual recovery between 4 to 6 weeks.However,the technology has advanced and it can be performed by 'Endoscopic Micro Discectomy" with the patient able to continue his normal life in two days.
Discectomy
A Discectomy is the surgical removal of herniated disc material that presses on a nerve root or the spinal cord. The procedure involves removing the central portion of an intervertebral disc, the nucleus pulposus, which causes pain by stressing the spinal cord or radiating nerves...
and fusion (ACDF) is a surgical procedure to treat nerve root or spinal cord compression by decompressing the spinal cord
Spinal cord
The spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the brain . The brain and spinal cord together make up the central nervous system...
and nerve roots of the cervical spine in order to stabilize the corresponding vertebrae. This procedure is used when other non-surgical treatments have failed.
Nucleus pulposus
Nucleus pulposus is the jelly-like substance in the middle of the spinal disc. It is the remnant of the notochord . It functions to distribute hydraulic pressure in all directions within each disc under compressive loads. The nucleus pulposus consists of chondrocyte-like cells, collagen fibrils,...
(the jelly-like center of the disc) of the hernia
Hernia
A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. A hiatal hernia occurs when the stomach protrudes into the mediastinum through the esophageal opening in the diaphragm....
ted disc bulges out through the annulus
Annulus fibrosus disci intervertebralis
Each intervertebral fibrocartilage is composed, at its circumference, of laminæ of fibrous tissue and fibrocartilage, forming the annulus fibrosus.-Spelling notes:...
(surrounding wall) and presses on the nerve root next to it. This nerve root becomes inflamed and causes serious pain. The problem can also be caused by degenerative disc disease (spondylosis
Spondylosis
Spondylosis is a term referring to degenerative osteoarthritis of the joints between the centra of the spinal vertebrae and/or neural foraminae. If this condition occurs in the zygapophysial joints, it can be considered facet syndrome...
). The disc consists of about 80 % water. When one grows older, the disc starts to dry out and shrink, causing small tears in the annulus and inflammation of the nerve root.
The neurosurgeon or orthopedic surgeon enters the space between two discs through a small incision in front (= anterior) of and at the right or left side of the neck. The disc is completely removed, as well as arthritic
Arthritis
Arthritis is a form of joint disorder that involves inflammation of one or more joints....
bone spurs. The disc material, pressing on the spinal nerve or spinal cord, is then completely removed. The intervertebral foramen, the bone channel through which the spinal nerve runs, is then enlarged with a drill giving the nerve more room to exit the spinal canal.
To prevent the vertebrae from collapsing and to increase stability, the open space is often filled with bone graft, taken from the pelvis
Pelvis
In human anatomy, the pelvis is the lower part of the trunk, between the abdomen and the lower limbs .The pelvis includes several structures:...
or cadaveric bone. The slow process of the bone graft joining the vertebrae together is called "fusion". Sometimes a titanium
Titanium
Titanium is a chemical element with the symbol Ti and atomic number 22. It has a low density and is a strong, lustrous, corrosion-resistant transition metal with a silver color....
plate is screwed on the vertebrae or screws are used between the vertebrae to increase stability during fusion, especially when there is more than one disc involved.
The surgery requires a short stay in the clinic (1 to 3 days) and a gradual recovery between 4 to 6 weeks.However,the technology has advanced and it can be performed by 'Endoscopic Micro Discectomy" with the patient able to continue his normal life in two days.
Sources
External links
- Information for patients - includes discectomy and fusion information