When a cervical disease encompasses more than just the disc space, a spine surgeon may recommend the removal of the vertebral body and the disc spaces at either end to decompress the cervical canal completely. This procedure is called an anterior cervical corpectomy and fusion and is often done for multi-level cervical stenosis with spinal cord compression caused by bone spur growth.
An anterior cervical corpectomy and fusion is a procedure that removes the damaged vertebrae and intervertebral discs, compressing the spinal cord and spinal nerves.
An ACCF is similar to a related procedure called a discectomy. The two surgeries can be used to treat similar conditions. The difference is that an ACCF is a more extensive procedure used when the disease has extended beyond the areas that can be dealt with through a discectomy. In a discectomy, only the damaged area of a disc and bone spurs are moved, but in an ACCF, the discs, bone spurs, and vertebrae are removed.
During an ACCF procedure, a larger and more vertical incision is made in the neck to allow more exposure to remove entire vertebrae. Once the discs, bone spurs, and vertebrae are removed, a spinal fusion is performed to stabilize the spine. Spinal fusion is a welding process used to help the spinal bones heal into a single and solid bone. The fusion takes away some of the spine’s flexibility.
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An anterior cervical corpectomy and fusion procedure is performed for patients experiencing degenerative changes in their cervical spine that have caused the formation of bone spurs or herniated discs. These degenerative changes take up space needed by the spinal cord and nerves within the spinal canal. As a result, the spinal cord and nerves become compressed and injured. When the size of the spinal canal is damaged, it can begin to narrow, meaning there is less room for the spinal nerves and cord to move, causing pressure on the spinal structure.
Conditions that can cause nerve root compression include:
These conditions can cause severe discomfort and pain. It’s important to consult a spinal specialist to determine the best treatment plan possible. An ACCF will likely not be the first treatment option. However, when the condition has not significantly improved with non-operative measures, it may be time for an ACCF.
Anterior cervical corpectomy and fusion are performed for the following reasons:
Once a cervical disease or cervical damage has expanded from the disc space, an ACCF procedure can help relieve the pain.
Like many medical procedures, an anterior cervical corpectomy and fusion is not without risk. An ACCF is an extensive procedure that can have complications such as:
It’s important to remember that ACCF procedures are most often performed in circumstances of significant spinal cord problems, which place the spinal cord at a greater risk for problems during surgery, independent of the skills with which the procedure is performed.
Many patients are able to go home four or five days after the surgery. Before they go, patients will work with physical therapists and occupational therapists to learn proper techniques for moving around independently. Patients are instructed to avoid bending and twisting the neck the first four to six weeks after the surgery. Additionally, patients should avoid heavy lifting during those first four to six weeks. After six to eight weeks, patients can gradually begin to bend and twist their neck as the pain subsides and the muscles in the neck and back begin to strengthen.
Patients will likely wear a neck brace or cervicothoracic brace to reduce the stress around the neck area and decrease pain. The brace can also help improve bone healing by maintaining the neck in a rigid position, especially during those first few weeks following the surgery.
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