Our Summary

This article discusses a popular surgery for treating degenerative neck disease, known as Anterior Cervical Discectomy and Fusion (ACDF). The surgery involves the use of bone grafts or interbody spacers, potentially supported with an anterior cervical plate, to replace damaged spinal discs. The article explains the various types of grafts and plating systems, and how to best evaluate these implants using CT and MR imaging. The images are crucial for checking on the patient after surgery, determining whether the fusion has been successful, and identifying any complications. The piece also discusses how issues at the level of the vertebral body can be treated at the same time through a procedure called corpectomy.

FAQs

  1. What is Anterior Cervical Discectomy and Fusion (ACDF) surgery?
  2. How are CT and MR imaging used in evaluating the success of the ACDF surgery?
  3. What is a corpectomy and how is it related to issues at the level of the vertebral body?

Doctor’s Tip

A helpful tip a doctor might tell a patient about discectomy is to follow all post-operative instructions carefully, including physical therapy exercises and restrictions on activities. It is important to give the body enough time to heal properly in order to achieve the best possible outcome from the surgery. Additionally, maintaining a healthy lifestyle with regular exercise and proper nutrition can help support the healing process and prevent future issues with the spine.

Suitable For

Patients who are typically recommended for discectomy are those who have been diagnosed with degenerative disc disease, herniated discs, spinal stenosis, or other conditions that are causing compression of the spinal cord or nerves in the neck. These patients may be experiencing symptoms such as neck pain, arm pain, weakness, numbness, or tingling. Discectomy surgery may be recommended when conservative treatments such as physical therapy, medications, or injections have not provided relief.

Candidates for discectomy surgery typically have symptoms that are severe, persistent, and impacting their daily activities and quality of life. They may also have evidence of nerve compression or spinal cord compression on imaging studies such as MRI or CT scans. Additionally, patients who have tried conservative treatments for a period of time without improvement may be considered for discectomy surgery.

It is important for patients to discuss their symptoms, medical history, and imaging studies with a spine specialist to determine if discectomy surgery is the best treatment option for their specific condition. The decision to undergo surgery should be made in collaboration with the patient’s healthcare provider, taking into account the potential risks and benefits of the procedure.

Timeline

Before the discectomy procedure, a patient may experience symptoms such as neck or arm pain, weakness, numbness, or tingling due to a herniated disc pressing on a nerve in the spine. They may undergo diagnostic tests such as X-rays, MRIs, or CT scans to confirm the diagnosis and determine the extent of the damage.

After the discectomy procedure, the patient will typically experience some pain and discomfort at the surgical site, which can be managed with pain medication. Physical therapy may be recommended to help restore strength and mobility in the neck and surrounding muscles. The patient will need to follow post-operative instructions, such as avoiding heavy lifting or bending, to allow the surgical site to heal properly. Follow-up appointments with the surgeon will be scheduled to monitor the healing process and address any concerns or complications that may arise. Over time, the patient should experience relief from their symptoms and improved function in the affected area.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a discectomy procedure?
  2. What is the success rate of this surgery in relieving symptoms and improving function?
  3. How long is the recovery process and what can I expect in terms of pain management and physical therapy?
  4. Are there any alternative treatments or procedures that I should consider before undergoing a discectomy?
  5. Will I need to wear a neck brace or take any medications after the surgery?
  6. How long do the effects of the surgery typically last, and are there any lifestyle changes I should make to prevent further disc degeneration?
  7. What type of follow-up care will be necessary after the surgery, and how often will I need to see my doctor for monitoring?
  8. Are there any restrictions on activities or movements that I should be aware of post-surgery?
  9. How experienced is the surgical team in performing discectomy procedures, and what is their success rate with similar cases?
  10. Can you provide me with any resources or information on support groups for individuals who have undergone a discectomy surgery?

Reference

Authors: Kani KK, Chew FS. Journal: Skeletal Radiol. 2018 Jan;47(1):7-17. doi: 10.1007/s00256-017-2798-z. Epub 2017 Oct 23. PMID: 29058045