Currently, the gold standard of treatment for cervical Degenerative Disc Disease or a cervical herniated disc is an Anterior Cervical Discectomy and Fusion.


What happens during surgery?

An anterior cervical discectomy with a fusion is an operation performed on the cervical spine to relieve pressure on one or more nerve roots, or on the spinal cord. The procedure is explained by the words anterior (front), cervical (neck), and discectomy (cutting out the disc).In this operation, the cervical spine is reached through an incision approximately one inch in length in the front of your neck. (See figure 2)

The approach to the anterior neck makes use of a plane between muscles, which is very easy to recover from. The muscles naturally part, giving the surgeon direct access to the spine, while avoiding the spinal cord. After the disc is exposed it is removed. Then the nerve root is decompressed, the offending compressive material is cleaned out, and then the bone graft is inserted into the disc space. The size of the bone graft has been determined by the surgeon prior to surgery. Once the bone graft is firmly in place, tension is taken off the vertebral bodies above and below, which compresses the bone graft and holds it in place.

In a single level fusion, the use of the patient's own bone versus bone from a bone bank yields similar results. If the fusion includes more than one level, the use of the patient's own bone as well as the use of a plate independently improves both symptomatic and surgical outcome. The decision to place plates and screws should be individualized for each patient.

Aside form solid, bony fusion; the main goal of any reconstructive surgery is to maintenance of the normal cervical lordosis (reverse C curve) of the individual. If the cervical disc is removed and the graft is not placed accurately, if the natural curvature of spine is not maintained, or the reconstructed area does not fuse properly, the cervical spine can collapse into kyphosis. The patient has a high probability of experiencing significant neck pain after surgery, and may be at risk for adjacent segment degeneration. To review a study about the Induction and Maintenance of Lordosis in the Cervical Spine, click here.

What happens after surgery?

The hospital stay is generally 24-48 hours. During this time, IV fluids may be given while your body recovers and your normal appetite returns. You may move about in bed and rest in any comfortable position when you have recovered from anesthesia. Walking may begin within several hours of surgery. Daily walking is the best exercise, setting a pace that avoids fatigue or severe pain. You may return to work when you are ready, and drive after you regain full coordination.

Successful recovery from Anterior Cervical Discectomy and Fusion requires that you approach the operation and recovery with confidence based on a thorough understanding of each process. Your surgeon has the training and expertise to correct physical defects by performing the operation; he and the rest of the health care team will support your body's efforts to heal its damaged tissues. Full recovery will also depend on you having a strong, positive attitude, setting small, realistic goals for improvement, and working steadily to accomplish each goal.