Anterior cervical discectomy with fusion is a surgical procedure that involves relieving the pressure placed on nerve roots and/or the spinal cord by a herniated disc or bone spurs in the neck.
Cervical refers to the 7 vertebrae of the neck. Discs are the spongy, cartilaginous pads between each pair of vertebrae, and ectomy means “to take out”. In a cervical discectomy, the surgeon accesses the cervical spine through a small incision in the neck and removes all or part of the disc – and/or in some cases boney spurs (osteophytes) which have been pressing on the nerves and causing pain.
Spinal fusion involves placing bone graft between two or more affected vertebrae to promote bone growth between the vertebral bodies. The graft material acts as a binding medium and also helps maintain normal disc height – as the body heals, the vertebral bone and bone graft eventually grow together to join the vertebrae and stabilize the spine.
Why Might I Need This Procedure?
If you have a herniated disc, this means that the nucleus pulposus – the soft, gel-like center of the disc – has pushed through the annulus fibrosus, the disc’s tough, outer ring. Boney spurs, also called osteophytes, can form when the discs degenerate.
Pressure placed on the spinal cord as it passes through the cervical spine can be serious, since most of the nerves for the rest of the body (e.g., arms, chest, abdomen, legs) must pass through the neck from the brain. A cervical discectomy can ease pressure on the nerves and/or spinal cord, ultimately providing pain relief.
Pressure placed on nerve roots, ligaments or the spinal cord by a herniated disc or bone spur may cause
- Pain in the neck and/or arms
- Lack of coordination
- Numbness or weakness in the arms or legs
- Male sexual dysfunction
An anterior cervical discectomy with spinal fusion is typically recommended only after non-surgical treatment methods fail. Dr. Rosenberg will take a number of factors into consideration before making this recommendation, including the condition to be treated, your age, health and lifestyle and your anticipated level of activity following surgery. Dr. Rosenberg will always explain your non-surgical option (if there is one) as well as the surgical option along with its success rate, failure rate and risks. Except when cancer or dangerous spinal instability is present, it is always Dr. Rosenberg’s advice that if you are then not sure about having surgery, you should choose not to have surgery for the moment. Stop, think, and let some time pass, and the correct way for you to manage your condition will become clear.
How Is An Anterior Cervical Discectomy With Fusion Performed?
Through a small incision made near the front of the neck, the surgeon
- Removes the intervertebral disc to access the compressed neural structures
- Relieves the pressure by removing the source of the compression
- Places a bone graft between the adjacent vertebrae and
- In some cases, uses instrumentation – metal plates or pins that will provide extra support and stability to help ensure proper fusion
How Long Will It Take Me To Recover?
Dr. Rosenberg will advise you in detail on the post-operative recovery/exercise plan to help you return to your normal activity level as soon as possible. The amount of time that you have to stay in the hospital will depend on this treatment plan. You typically will be up and walking in the hospital by the end of the first or second day after the surgery. You may return to work in 3-6 weeks, depending on how well your body is healing and the type of work/activity level you plan to return to.
Every patient is different, however, and Dr. Rosenberg will determine the appropriate recovery protocol for you. Please note that much of this advice is for your safety, and thus it is important that you follow it to the letter.
Are There Any Potential Risks Or Complications?
Any surgery and anaesthesia can result in injury or even, rarely, death. One only has to read the newspaper to confirm that fact. Complications such as infection, nerve damage, blood clots, blood loss and bowel and bladder problems, along with complications associated with anaesthesia, are some of the potential risks of spinal surgery. A potential risk inherent to spinal fusion is failure of the vertebral bone and graft to properly fuse, a condition that may require additional surgery.
Dr. Rosenberg will tell you the types and magnitudes of risks for you undergoing a given procedure.
The sorts of complications which can occur with surgery to cervical spine include the following:
- Implant failure
- Neck and/or arm pain
- Difficulty swallowing
- Voice Hoarseness
- Nerve or spinal cord injury, possibly causing impairment or paralysis
- Development or progression of disease at other cervical levels
- Bleeding or collection of clotted blood (hematoma)
- Reactions to anaesthesia