What is Anterior Cervical Discectomy and Fusion
Anterior cervical discectomy and fusion is a surgery to remove and replace an intervertebral disk. Intervertebral disks are plates of cartilage located between the bones of the spine. This surgery is done when an intervertebral disk in the neck puts pressure on the spine or on a nerve.
The surgery is done through the front (anterior) part of the neck. During the surgery, the damaged disk is removed and replaced with a plastic implant, a bone from another part of the body (bone graft), or both.
Sometimes metal plates and screws (hardware) are also put in the neck to help keep the implant or bone graft in place and to allow the bones to grow together (fuse).
Tell a health care provider about:
- Any allergies you have.
- All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
- Any problems you or family members have had with anesthetic medicines.
- Any blood disorders you have.
- Any surgeries you have had.
- Any medical conditions you have.
- Whether you are pregnant or may be pregnant.
What are the risks?
Generally, this is a safe procedure. However, problems may occur, including:
- Infection.
- Bleeding with the possible need for blood transfusion.
- Injury to surrounding structures, including nerves.
- Leakage of fluid from the brain or spinal cord (cerebrospinal fluid).
- Blood clots.
- Temporary breathing difficulties.
What happens before the procedure?
- Follow instructions from your health care provider about eating or drinking restrictions.
- Ask
your health care provider about:
- Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
- Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
- You may be given antibiotic medicines to help prevent infection.
What happens during the procedure?
- An IV tube will be inserted into one of your veins.
- You
will be given one or more of the following:
- A medicine that helps you relax (sedative).
- A medicine that makes you fall asleep (general anesthetic).
- A breathing tube will be placed.
- Your neck will be cleaned with a germ-killing solution (antiseptic solution).
- Your surgeon will make a cut (incision) in the front of your neck.
- Your neck muscles will be spread apart.
- The damaged disk and any damaged bone will be removed.
- The area where the disk was removed will be filled with a small plastic implant, a bone graft, or both.
- Hardware may be put in your neck.
- The incision will be closed with stitches (sutures).
- Adhesive strips or skin glue may be placed across the incision.
- A bandage (dressing) will be applied over the incision.
The procedure may vary among health care providers and hospitals.
What happens after the procedure?
- Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
- You
will be monitored for any signs of complications from the procedure, such
as:
- Too much bleeding from the incision site.
- A buildup of blood under your skin at the surgical site.
- Difficulty breathing.
- You may continue to receive antibiotics.
- You can start to eat as soon as you feel comfortable.
- You may be given a neck brace to wear. This brace limits your neck movement while your bones are fusing.
Anterior Cervical Diskectomy and Fusion, Care After
Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.
What can I expect after the procedure?
After the procedure, it is common to have:
- Neck pain.
- Discomfort when swallowing.
- Slight hoarseness.
Follow these instructions at home:
If You Have a Neck Brace:
- Wear it as told by your health care provider. Remove it only as told by your health care provider.
- Keep the brace clean and dry.
Incision care
- Follow
instructions from your health care provider about how to take care of the
cut made during surgery (incision). Make sure you:
- Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
- Change your dressing as told by your health care provider.
- Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.
- Check
your incision every day for signs of infection. Watch for:
- Redness, swelling, or pain.
- Fluid or blood.
- Warmth.
- Pus or a bad smell.
Managing pain, stiffness, and swelling
- Take over-the-counter and prescription medicines only as told by your health care provider.
- If directed,
apply ice to the injured area.
- Put ice in a plastic bag.
- Place a towel between your skin and the bag.
- Leave the ice on for 20 minutes, 2–3 times per day.
Activity
- Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
- Do exercises as told by your health care provider.
- Do notlift anything that is heavier than 10 lb (4.5 kg).
General instructions
- Do notdrive or operate heavy machinery while taking prescription pain medicines.
- Do notuse any tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. Tobacco can delay healing. If you need help quitting, ask your health care provider.
- Keep all follow-up visits and physical therapy appointments as told by your health care provider. This is important.
Contact a health care provider if:
- You have a fever.
- You have redness, swelling, or pain around your incision.
- You have fluid or blood coming from your incision.
- You have pus or a bad smell coming from your incision.
- You have pain that is not controlled by your pain medicine.
- You have increasing hoarseness or trouble swallowing.
Get help right away if:
- You have severe pain.
- You have sudden numbness or weakness in your arms.
- You have warmth, tenderness, or swelling in your calf.
- You have chest pain.
- You have difficulty breathing.
