MIS ACDF: Anterior Cervical Discectomy and Fusion

ACDF surgery, or Anterior Cervical Discectomy and Fusion, is a surgical procedure used to treat conditions affecting the cervical spine (neck), such as herniated discs, degenerative disc disease, or spinal stenosis, which may cause symptoms like neck pain, arm pain, or sciatica-like symptoms in the upper body. It involves removing a damaged disc in the cervical spine and fusing adjacent vertebrae to stabilize the area.

Overview

• Anterior Approach: The surgeon accesses the cervical spine through a small incision in the front of the neck, avoiding major muscles and nerves.
• Discectomy: The damaged or herniated disc (or discs) pressing on nerves or the spinal cord is removed to relieve pressure.
• Fusion: A bone graft or synthetic spacer is placed in the empty disc space to maintain alignment and promote bone growth between the vertebrae. A metal plate and screws are often used to stabilize the vertebrae during fusion.
• Closure: The incision is closed, typically leaving a small scar.

Conditions Treated

• Herniated cervical disc causing nerve compression (radiculopathy) or spinal cord compression (myelopathy).
• Degenerative disc disease leading to pain or instability.
• Cervical spinal stenosis.
• Fractures or trauma to the cervical spine.
• Occasionally, tumors or infections affecting the spine.

Benefits

• Relieves nerve-related symptoms like arm pain, numbness, or weakness.
• Stabilizes the spine to prevent further damage.
• High success rate (80-90% for symptom relief in appropriately selected patients).

Risks and Complications

• General surgical risks: infection, bleeding, or anesthesia complications.
• Specific risks: difficulty swallowing (dysphagia, usually temporary), hoarseness (from vocal cord nerve irritation), or nonunion (failure of bones to fuse, ~5-10% risk).
• Rare risks: nerve or spinal cord injury, implant failure, or adjacent segment disease (degeneration of nearby discs over time).

Recovery

• Hospital Stay: Typically 1-2 days, sometimes outpatient for single-level procedures.
• Recovery Time: Most patients resume light activities within 2-6 weeks. Full fusion may take 6-12 months.
• Post-Op Care: Wearing a cervical collar (if prescribed), physical therapy, and avoiding strenuous activities like heavy lifting.
• Pain Relief: Arm pain often improves soon after surgery; neck stiffness may persist temporarily.

Comparison of Minimally Invasive Spine Surgery Approaches