Anterior Cervical Discectomy, Decompression and Fusion for the Treatment of Pain, Weakness, Numbness and Tingling in the Neck and Arm caused by Radiculopathy or Myelopathy.
Last updated Tuesday, January 15, 2008
About the procedureTechnical details
After the
anesthesia is administered and the patient is given prophylactic antibiotic, a
horizontal incision (3 cm to 4 cm) is made on the front of the neck. This
incision is made in line with the way the skin runs, so it can heal along skin
lines with minimal scarring.
Dissection
through superficial muscle layers, around the midline esophagus and airway
structures, and onto the cervical spine is then performed. Retractors are
placed. An intra-operative X-ray is performed to confirm the appropriate level
of surgery.
The
intervertebral disc is then completely removed. A foraminotomy can also be
performed; this is the direct decompression of the space through which the
nerve root travels. Disc material or bone spurs can impinge in this area, and
place pressure on the nerve root.
After
discectomy (removal of the disc) and foraminotomy (decompression of the nerve
root), partial or complete removal of the vertebral body can be done. The
decision to remove the vertebra (corpectomy) is dependent upon the nature of
the condition. This may or may not be necessary.
After
adequate decompression of the spinal cord and or nerve roots, a bone graft is
then impacted into place where the disc was removed, between the two vertebrae.
A small
titanium plate is then placed on top of the bone graft and into the bone above
and below Screws are placed into the bone above and below to hold the plate in
place. This plate gives additional stability to the structure.
The
surgical wound is then washed out, and the layers are closed with suture. The
skin is closed with an absorbable suture, and there is no need for suture or
staple removal. A drain is placed for 24 hours and is removed the next day.
The
patient is placed in a soft neck collar postoperatively, typically for a few
weeks.Anesthetic General
anesthesia is necessary to perform this procedure. For spine procedures, it is
generally advisable to have the patient go to sleep for their anesthesia than
to be partially awake. With such meticulous dissection around the spinal cord
and nerve tissue, sudden inadvertent patient motion may result in injury.Length of anterior cervical decompression and fusion (acdf) Cervical
stenosis can occur at one particular location in the cervical spine, or at
multiple levels. The length of the procedure depends on the number of levels and whether the vertebral body is
being removed. In general, the procedure takes 45 minutes to two hours.Surgery for Cervical Stenosis at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 (outside the Seattle area: 800-440-3280) to make an appointment.
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