ACDF: Anterior cervical discectomy with bone fusion

This procedure has been used since the 1950s and is one of the routine operations carried out on the cervical spine. It was recognised early on that the sensitive spinal cord must not be touched during an operation. Since then admission to the disc prolapses and to thoracic narrowing has been developed, which narrow the spinal cord canal and press on the spinal cord from the front. Through a cut on the left or right side of the neck, the spinal column is shown from the front, between the thyroid and trachea on the one side and the vascular bundle of nerves on the other side.

After identifying the segments treated, screws are introduced to the vertebra, and then the disc is gradually removed. Under the microscope the osseous growths are removed and the spinal canal itself and the nerve canals are widened. The vertebrae are spread apart gently. A plate is placed in the empty intervertebral disc space, leading to a fusion of the 2 vertebrae concerned. At the start, they used bone pegs, which were taken from the iliac crest. Nowadays PEEK (Polyethyletherketone), a type of plastic, plates (cages) or even metal cages are used. It is therefore no longer necessary to perform an often painful bone removal on the iliac crest.

As a consequence of the fusion, there can subsequently be a degeneration of the segments located above or below. Hence operations to maintain mobility such as ADR were developed, in order to prevent this wherever possible. The operation is always carried out under a general anaesthetic. According to the findings, sometimes a soft neck collar is prescribed for the first few days and/or weeks. The patient can usually be mobile on the first day. The length of stay in hospital is of around 4-5 days. For some weeks the patient should avoid sudden head movements.

Bandscheibendeg. C4:5 und C5:6, Enge+ProlapsBandscheibendeg. C4:5 und C5:6, Enge+Prolaps,2

Disc degeneration and prolapse of C4 / 5, C5 / 6 (red arrows)

cage HWS detail

PEEK-Cage

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