What Is Anterior Cervical Discectomy & Fusion Surgery?
Anterior cervical discectomy and fusion is a spinal operation, performed on the upper back/neck area. The operation is twofold, combining a discectomy and fusion operation. A discectomy is primarily performed when a nerve is put under pressure from a slipped disc. In general terms the surgeon will surgically remove the all or part of the disc that is producing the nerve pain down the arms.
A fusion is a surgery that is done to link together two or more vertebrae when there is a problem with the disc space. By linking together (fusing) the vertebrae, your surgeon is trying to eliminate the motion that occurs within that portion of the spine. The surgeon may opt to use specialised spinal instruments, called a fusion cage, to increase the stability of the spine.
Why Is This Surgery Suitable For Me?
Surgery is an option if:
- painkillers, rest, exercises and injections don’t help
- there is a likelihood of serious complications involving the nerves if left untreated
- when the pain in the neck, upper back and arms is having a profound effect on your quality of life
The aim of Anterior Cervical Disc Replacement & Fusion Surgery is to reduce the pain in the neck, back and arms and increase mobility.
How Is It Performed?
Anterior Cervical Disc Replacement & Fusion Surgery is performed under general anaesthetic. The surgical approach for an anterior procedure is from the front, a 3cm incision is made into the neck. The major blood vessels are retracted. The problem disc is identified and confirmed with X-ray. The surgeon will remove part or all of the disc and any protruding bony fragments, freeing the nerve. A metal fusion cage may be inserted to help stabilise the spine. X-ray images will confirm the cage has been fitted in the correct position. You will need a minimum two night stay in Hospital. Following surgery, you will need to undergo a physiotherapy-based rehabilitation program.
Surgery seems to get people better quicker but has some risks associated with it.
If you have had pressure on the nerve for a long time or the nerve has become damaged by the pressure, you may not get a complete recovery of the nerve function. This means that you might always have some numbness in parts of the arm or legs, or weakness of some of the muscles after surgery.
Surgery has less risk, and is safer, on fit and healthy patients. It is common sense to take responsibility as a patient to reduce the risks whenever possible. Simple measures such as stopping smoking, losing weight and improving aerobic fitness all help.
- Infection of your wound after surgery, which is not usually serious and can be treated with antibiotics (deeper spinal infection is more serious but very rare) (occurs in 1-2% of cases)
- Damage to nerves and blood vessels, which occurs in rare cases (1%)
- Paralysis, which could occur if there is bleeding into the spinal canal after surgery or the blood supply of spinal nerves is damaged (<1%)
- Difficulty swallowing, caused by a temporary swelling of the neck (8%)
- Hoarse voice, if the nerve to the voice box is injured you may have a temporary speech problems, in rarer cases when the nerve is cut, the problems may be ongoing (10%)
- Implant failure, if the body rejects the implant, a further operation may be required. Alternatively if the implant moves and press on the nerves, the initial symptoms may return (5%)
- Failure of fusion, if the bones fail to fuse together, neck pain can recur and a further operation may be considered (15%)
- Rare complications associated with general anaesthetic, such as heart attack, blood clot in the lung or an allergic reaction