Anterior Cervical Discectomy with Fusion



What is it?

Pain in the neck and extremities, among other symptoms, may occur when an intervertebral disc herniates - when the annulus fibrosus (tough, outer ring) of the disc tears and the nucleus pulposus (soft, jelly-like center) squeezes out and places pressure on neural structures, such as nerve roots or the spinal cord. Bony outgrowths, called bone spurs or osteophytes, which form when the joints of the spine calcify, may also cause these symptoms.

Anterior cervical discectomy with fusion is an operation that involves relieving the pressure placed on nerve roots and/or the spinal cord by a herniated disc or bone spurs - a condition referred to as nerve root compression.

Through a small incision made near the front of the neck (i.e., the anterior cervical spine), 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, implants a small metal plate to stabilize the spine while it heals.

Discectomy involves removing all or part of an intervertebral disc. The term discectomy is derived from the Latin words discus (flat, circular object or plate) and -ectomy (removal). Spinal fusion involves placing bone graft between two or more opposing vertebrae to promote bone growth between the vertebral bodies.

Why is it done?

Pressure placed on neural structures, such as nerve roots or the spinal cord, by a herniated disc or bone spur may irritate these neural structures and cause: pain in the neck and/or arms; and lack of coordination, numbness or weakness in the arms, forearms or fingers. Pressure placed on the spinal cord as it passes through the neck (cervical spine) can be serious since most the nerves for rest of the body (e.g., arms, chest, abdomen, legs) have to pass through the neck from the brain.

Patients who suffer from these symptoms are potential candidates for this operation.

Anterior Cervical SpineAnterior Cervical Exposure

The Operation

An understanding of what an anterior cervical discectomy with fusion involves will help you to approach your operation and recovery with confidence.

Incision

The operation is performed with you lying on your back. A small incision is made to one side of the front of your neck.Anterior Cervical Discectomy

Exposure

After pulling aside the soft tissue - fat and muscle, your surgeon exposes the disc between the vertebrae.

Removal

The intervertebral disc - and, in some cases, a portion of the bone around the nerve roots and/or spinal cord - is then removed to relieve the compressed neural structures and to give them additional space.

Material Placement

Through a separate incision, a small section of bone is obtained from your iliac crest (i.e., your hip) for use as a bone graft. The bone graft is placed in the disc space, where it helps the adjacent vertebrae to fuse.Anterior Cervical Stabilization

Stabilization

A metal plate may be implanted on the front of the cervical spine to increase the stability of the spine immediately after the operation. Surgeons use these implants to decrease the amount of time that you have to wear a cervical collar after surgery and to increase your chances of developing a solid fusion.

Closure

The operation is completed when your surgeon closes and dresses the incision.

Recovery

Your surgeon will have a specific post-operative recovery/exercise plan to help you return to normal life as soon as possible. The amount of time that you have to stay in the hospital will depend on this treatment plan. You will normally be up and walking in the hospital by the end of the first day after the surgery.


It is important that you discuss the potential risks, complications, and benefits of spinal surgery with your doctor prior to receiving treatment, and that you rely on your physician's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.

Published: April 11, 2007
Updated: May 25, 2007