Anterior Cervical Discectomy & Fusion with Cage
An anterior cervical discectomy and fusion is a surgery designed to take two vertebrae in your neck and “weld” them together with a piece of bone. The bone is taken from your pelvis or from a cadaver (allograft bone) and is placed between the vertebrae in the front (anterior) part of your cervical spine. The bone is placed in the area of the spine that is degenerated, and the disc is completely removed. It takes the body approximately 6 months to fuse these together solidly.
Anterior cervical discectomy and fusion is generally designed to relieve pressure upon the spinal cord or nerve roots. In most cases, patients have severe neck or arm pain from pinching of the spinal cord or nerves. Sometimes patients experience myelopathy or weakness in the legs. Other indications include instability due to disc degeneration, fracture, or tumor.
The procedure takes about 2 hours to perform. An incision is made across the front part of your neck, usually on the left side. The incision goes past your esophagus and trachea, and your spine is directly under this area. The entire disc is removed and then a piece of bone is put in its place, this can come from your pelvis or a cadaver. Usually, a metal plate and screws are then placed on the spine to stabilize the area of surgery. After surgery, you are sometimes hoarse and there may be some difficulty involved in swallowing. You can get up and around the day of surgery and will be in a soft collar.
One risk is that the bone placed between your vertebrae might not fuse and there would be a nonunion of this area. However, we find that the fibrous tissue and scar tissue that form are usually enough to take care of pain relief. Nonunion happens about 2% of the time in nonsmokers.
Infection is a complication that occurs about 1% of the time. This may require further surgery, and/or antibiotics.
Another risk is that of damaging the vocal cords so that you may be permanently hoarse.
Other potential complications are damage to the esophagus and arteries in the neck area. These are potentially very serious complications, which may lead to severe neurological complications, including paralysis. However, the incidence is extremely low.
The risk of a spinal fluid leak is less than 1% but can lead to prolonged hospitalization while patients recover.
There is approximately a 90% chance you will benefit from the operation. There is a slight chance that the symptoms may be worse afterward, but that is not common.
Our overall advice for this type of surgery is the same for any other spine surgery, which is to live with the pain you are experiencing if you can. The reason for undergoing the operation is that the pain or weakness is making life so uncomfortable or difficult that you are willing to accept the chance of a result that is less than 100% successful.