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Anterior Cervical Discectomy And FusionAnterior cervical discectomy and fusion (ACDF) is an operation on the spine at the level of the neck. It is recommended most often when patients have neurologic symptoms (pain, numbness/tingling, or weakness) down the arm being caused by a disc herniation or a bone spur (spinal stenosis). It involves making an incision on the front of the neck, most often on the left but can be on the right side based on surgeon preference.Once access is obtained, the disc(s) to be operated on should be confirmed using an x-ray or fluoroscope. Once this is done, retractors are placed and a microscope is used. The disc and/or bone spurs are removed and the spinal cord and/or the nerves are decompressed (make more room and relieve the pressure). The vertebrae are then prepared by removing the cartilage on them to help incorporate the fusion. Next, a spacer is placed in between the vertebrae. This can be bone from the pelvis (ilium), cadaver bone graft, or a plastic spacer filled with bone. A plate is then placed to hold the entire reconstruction in place. The metallic plate maintains the alignment and the graft spacers in place while the fusion takes. The bone growing and integrating in between the vertebrae is called a spinal fusion. Typically, my patients are in a brace for 8-12 weeks. This helps minimize motion at the fusion area to decrease the chances on the fusion not taking (pseudoarthrosis). When one level is fused (one disc in between two vertebrae), the bracing period is less.Risk factors for the fusion not taking are too much movement after surgery out of the brace, smoking, medical problems like osteoporosis and diabetes, and three or more levels fused.Success rates range from 70-90% and complications are minimal. I typically follow my patients for two years to insure a stable and successful result. ................
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