Our Summary

This study looks at how well the neck bones fuse together after a type of surgery called Anterior Cervical Discectomy and Fusion (ACDF). This is a procedure to relieve pain in the arm caused by problems in the neck. After the surgery, the neck bones need to fuse together for the neck to regain its stability.

The researchers reviewed 146 articles, involving over 10,000 patients, to understand how well and how quickly this fusion happens. They found that, in about 90% of cases, the bones had fused together a year after the surgery.

However, they noted that there isn’t a universally agreed-upon way to define or measure this fusion, which makes it difficult to determine the best method. They also found that using certain materials or techniques during surgery can slightly improve the chances of successful fusion, but these differences weren’t big enough to be clinically important.

Finally, the researchers observed that not enough attention is paid to the relationship between successful bone fusion and the patient’s clinical outcome. Only 18 of the studies they reviewed had considered this, and just 3 found a significant link between successful bone fusion and better patient outcomes.

In other words, we need more research to understand the best ways to ensure successful bone fusion after ACDF, and to understand how this affects patient recovery.

FAQs

  1. What is Anterior Cervical Discectomy and Fusion (ACDF) and why is it performed?
  2. How often do neck bones successfully fuse together after ACDF surgery?
  3. Does successful bone fusion after ACDF surgery have a significant impact on the patient’s recovery?

Doctor’s Tip

A helpful tip a doctor might give a patient about discectomy is to follow post-operative care instructions carefully, including proper wound care, physical therapy, and activity restrictions. It is important to give the bones time to heal and fuse together properly in order to achieve the best possible outcome. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help support the healing process and prevent future spine issues.

Suitable For

Patients who are typically recommended for discectomy are those who have severe pain, weakness, or numbness in their arms or legs due to a herniated disc in the spine. These symptoms are often caused by pressure on the nerves in the spine, which can be relieved by removing the herniated disc through surgery. Discectomy is usually recommended after conservative treatments such as physical therapy, medications, or injections have not provided sufficient relief. Additionally, patients who have a herniated disc that is causing significant neurological deficits, such as difficulty walking or loss of bladder or bowel control, may also be candidates for discectomy.

Timeline

  • Before Discectomy:
  1. Patient experiences neck or arm pain, weakness, numbness, or tingling due to a herniated disc in the neck.
  2. Patient consults with a doctor, undergoes imaging tests (such as MRI or CT scan) to confirm the diagnosis.
  3. Doctor recommends discectomy surgery to remove the herniated disc and relieve pressure on the nerves.
  4. Patient undergoes pre-operative testing and preparation for surgery.
  • After Discectomy:
  1. Patient undergoes the discectomy surgery, which involves removing the herniated disc and possibly fusing the neck bones together.
  2. Patient stays in the hospital for a few days for monitoring and recovery.
  3. Patient may experience some pain, swelling, and stiffness in the neck and shoulder area post-surgery.
  4. Patient begins physical therapy and rehabilitation to regain strength and range of motion in the neck.
  5. Patient follows up with the doctor for post-operative appointments and monitoring of their recovery progress.

What to Ask Your Doctor

  1. What is the success rate of bone fusion after a discectomy procedure like Anterior Cervical Discectomy and Fusion (ACDF)?

  2. How long does it typically take for the bones to fuse together after the surgery?

  3. Are there any specific materials or techniques used during surgery that can improve the chances of successful fusion?

  4. How will successful bone fusion impact my overall recovery and outcome?

  5. What are the potential risks or complications associated with bone fusion after a discectomy procedure?

  6. Are there any specific post-operative precautions or activities I should avoid to promote successful bone fusion?

  7. How often will I need follow-up appointments to monitor the progress of bone fusion?

  8. Is there anything I can do to help promote successful bone fusion, such as maintaining a healthy lifestyle or physical therapy exercises?

  9. What are the signs or symptoms that may indicate a problem with bone fusion after the surgery?

  10. Are there any additional treatments or interventions that can be considered if bone fusion is not successful?

Reference

Authors: Noordhoek I, Koning MT, Vleggeert-Lankamp CLA. Journal: Eur Spine J. 2019 Feb;28(2):386-399. doi: 10.1007/s00586-018-5820-9. Epub 2018 Nov 17. PMID: 30448985