One of the treatment options for cervical disc problems is an ACDF. A cervical discectomy entails removing a damaged cervical disc and thereby relieving spinal nerve or spinal cord compression. The anterior approach refers to the removal of portions of the disc through an incision in the front of the neck. Most of the approach through the incision is between the esophagus and the muscles in the front part of the neck. The procedure is often done with the aid of a surgical microscope to improve visualization and safety.The majority of the disc is removed in this process. Surrounding bone spurs are usually removed as well. This procedure can dramatically reduce pain and other symptoms.
A discectomy can effectively relieve pressure on the nerves in spinal cord, but it often causes spinal instability because one or more discs are now missing. A spinal fusion, which joins the vertebrae above and below the disc, helps solve this problem.
A fusion in its strictest sense refers only to joining two bones together by new bone growth. In usual usage, however, the fusion includes the placement of spinal instrumentation to help that bone grow.
After the discectomy is complete, the space is filled by some sort of spacer. The spacer may be the patient’s own bone from his or her hip. This is less commonly done today due to the persistent pain that can result from the hip. More often, the spacer is a pre-formed piece of human cadaver bone, a type of plastic called PEEK (polyether-ether-ketone) or metal. The PEEK and metal spacers often are ring shaped to allow the placement of cadaver bone within it.
Once the spacer is in place a thin metal plate is attached to the spine with screws for additional stability. The plate limits the movement of the vertebrae where the surgery took place so that the bone has a better chance of growing.