Surgical procedure for a prolapsed disc in neck?

Anterior Cervical Discectomy and Fusion (ACDF)

Anterior Cervical Discectomy and Fusion (ACDF) is a fusion procedure for worsening pain in the neck and arm pain. Here, the bones segments of the spine are joined up together (fused) to stop the movement between the segments. MRI scans usually show a disc prolapse (bulging disc) in the neck that may be the cause of your neck and arm pain. The prolapsed disc presses on the nerve that come out of the spine and supplies sensation and power to your arms, hands and fingers. There is neck pain that travels down your arm with pins and needles and occasional numbness.

When is ACDF considered?

Anterior cervical discectomy and fusion (ACDF) is offered to patients who have gone through all conservative measures like physiotherapy, injections and pain management medications. They are not able to control the neck pain and arm pain and therefore choose to have this procedure done. The surgical procedure involves the use of microsurgical techniques to gain access to the cervical spine in the neck.

What happens before the procedure?        

Before the procedure, you will be required to coming to the hospital for admission the night before so that we have enough time to do the necessary blood tests, check your blood pressure, temperature and make sure that you are safe and healthy for the procedure. This will also give the anaesthetist who puts you to sleep enough time to check your health and medication and advise on the time of fasting before the procedure.

You will be advised to:

    • Bring are your medications including the prescription
    • Stop all tablets that causes your blood to become thin
    • Have a blood test to check your fitness for the procedure

The surgeon and his team will make sure that you’re comfortable and you had all the necessary information.

How is the procedure done?

You will be given a general anaesthesia may have an experienced anaesthetist. You will have to lie flat on your back and the surgeon makes a small incision in front of your neck. With the use of a microscope, he opens the spinal canal and removes the disc that presses on the nerve that causes neck and arm pain. The whole disc is removed and a synthetic cage is used to replace the disc. This maintains the height and alignment of the spine.  The incision in front of the neck is closed with absorbable sutures. You may have a drain from the wound so that there are no complications from bleeding inside the wound.

There are huge benefits from microscopic discectomy procedure. There is less muscle dissection and there is a great view for the surgeon which ensures safety of the procedure. It reduces the risk of complications and the pain after the procedure is very minimal and you hardly have any discomfort during recovery.

What happens after the procedure?

After the procedure the anaesthetist will make sure that you wake up from the anaesthesia safely and when he is satisfied, he will arrange you to be transferred to the recovery room. Once you’re fully awake and ready you will be transferred to your room. The drain will be removed after 24 to 48 hours and the physiotherapist and the spine specialist nurse will help you to get up and take a few steps. When the surgeon and his team are both satisfied with your progress you will be discharged from the hospital with a clear set of instructions to follow.

Discharge after Anterior Cervical Discectomy and Fusion (ACDF)

At the time of discharge from the hospital the spine team will give you a booklet and discharge summary that will have the details of the surgical procedure, medications to continue, physiotherapy exercises to follow along with a follow-up appointment date and time.

What should I do at home?

When you reach home make sure that you have adequate rest so that the soft tissues around your neck has enough time to heal well. Make sure that you gradually increase your activities with enough support to move around in the first few days. Try to follow the physiotherapist and the Spine team’s advice when you sit, stand and get on and off the bed. You will need to take your medication at least for the first few weeks, so that is very little discomfort when you start getting back to normal activity

Anything that I should look out for after ACDF Surgery?

It is very important that the surgical wound is not wet when you wash and clean yourself at least for the first 14 days after the procedure. Be careful on how much you move your neck in the first few weeks and please let us know if there are any problems or concerns that bothers you. Do not bend or lift anything before the surgeon allows you to do so.

 The secretary will book and arrange a follow-up appointment in about two weeks’ time to see the surgeon so that he can check your wound. You’ll be advised physiotherapy rehabilitation for a period of 4 to 6 weeks so that you get back to full action in the shortest possible time.

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