Between the vertebrae that make up the neck—also known as the cervical spine—small discs cushion the spine and it’s movements. Unfortunately, these discs are prone to injury because of aging, trauma, and disease. In some cases, an anterior cervical discectomy (ACD) can eliminate the pain and other symptoms caused by these damaged discs.
Intervertebral discs are circular structures found between most vertebrae. They have a tough outer layer known as the annulus fibrosus. The annulus fibrosus surrounds the gel-like interior of the disc known as the nucleus pulposus.
Early in our lives, these discs are strong and well-hydrated. Unfortunately, however, they lack a blood supply. So, as the discs endure the stress of our everyday movements, they gradually begin to lose shape and dry out. This makes them infinitely more prone to injuries.
For example, a herniated disc occurs when the annulus fibrosis tears, causing some of the gel-like center of the disc to leak out. Moreover, the nucleus pulposus contains inflammatory proteins inside. As a result, these proteins may leak onto a nearby nerve root (i.e.the place where the spinal cord branches out to other parts of the body). In rare cases, the herniated disc may even leak onto the spinal cord.
Symptoms of a herniated disc include mild to sharp pain in the neck. Sometimes the pain radiates down through the shoulder, arm, and hand. Furthermore, if the damaged disc causes a pinched nerve in the neck, then you may feel numbness or weakness down the shoulder, arm, and hand. Certain head movements or activities can cause the pain to worsen. In addition, the pain can result in neck stiffness and reduced range of motion.
Are you dealing with these cervical disc problems? Is the injury affecting your everyday life despite months of trying conservative treatments? If so, then you may want to talk to your doctor about the possibility of an anterior cervical discectomy.
The term “discectomy” refers to removing a damaged, diseased, or herniated disc. “Anterior” means conducting the surgery at the front of the body. And “cervical”, as you probably know, means the neck.
Now, putting the terms together, anterior cervical discectomy (ACD) means removing a disc in the neck area of the spine. The surgical incision is made at the front of the neck. Most of the time, an ACD procedure also involves a fusion or fixation to ensure that the spine is stable after removing the disc.
A fusion involves grafting a piece of bone into the area where the disc was removed. In time, the two adjacent vertebrae fuse as one and the spine stabilizes. Fixation, on the other hand, involves surgical hardware such as screws, rods, and plates to hold the bone in place while it fuses. These techniques are often performed in conjunction with one another.
To prepare for the surgery, you will be placed under general anesthesia. This means that you will be asleep for the duration of the surgery.
In many cases, this procedure is performed in a minimally invasive fashion. The surgeon makes a small incision at the front of the neck. Then, using a tiny camera and surgical tools, the surgeon removes the damaged disc as well as any bone overgrowth—known as bone spurs—that may be applying pressure on the nerves.
Once the disc is removed and the area is cleared of bone spurs, the surgeon typically uses a bone graft or surgical hardware to align and stabilize the spine. Sometimes the surgeon may elect to use an artificial disc instead of a bone graft.
Subsequently, sutures are placed beneath the skin. The incision site is then covered in gauze and sterilized bandages. You will then move to a recovery room where your vital signs are monitored until you wake up.
Most people spend a night or two in the hospital after an ACD surgery. After returning home, they generally need to reduce their activities and participate in physical rehabilitation. But, more on that in the next section…
Do you wonder if your neck pain and other issues can be eliminated with an anterior cervical discectomy? How about trying our Treatment Finder tool to learn about your treatment options. Just answer a few questions and you will discover the relevant treatments NJ Spine & Orthopedic can provide to help with your neck pain.
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In many cases, an anterior cervical discectomy is a minimally invasive procedure to resolve a herniated cervical disc or spinal bone spurs. This means the surgeon uses a very small camera, known as an endoscope, to obtain an accurate look at the area. Once the damaged disc is located, the surgeon removes the disc with tiny surgical equipment and stabilizes the spine. Compared to open surgeries, these procedures offer several notable advantages.
Consider this: A minimally invasive anterior cervical discectomy uses an incision only about an inch long.
What does that mean for you? Quite a bit, actually, including:
As you can see, if you qualify for a minimally invasive anterior cervical discectomy (ACD), it certainly has its advantages. Of course, the best way to find out if you qualify for this procedure is talking to a qualified orthopedic surgeon who specializes in issues with the spine—especially the cervical spine.
We’re sure you probably still have some questions about the procedure. Here are some common items about which our patients request more information:
You may think that it would be easier to remove a disc from the back of the neck. After all, making an incision at the front of the neck means the throat and esophagus are in the way. In reality, however, operating from the back of the neck is actually more complicated. Believe it or not, it’s easier to gently displace the soft tissues at the front of the neck for a short period of time.
Operating from the back of the neck is more difficult because there are many veins and blood vessels residing in the area. This can result in more blood loss which can complicate the surgery and prolong recovery. In addition, the surgeons have more muscles to contend with that they may have to cut through to gain access to the affected area. Again, this often means longer recovery times for you. And, finally, some herniated discs are much easier to access through the front of the neck. (The main exception to this is laterally herniated cervical discs, i.e. discs that protrude out of the side of the spine.)
Recovery time will vary based on the severity of your condition, any complications occurring after the surgery, and your dedication to following postoperative instructions and rehabilitation. That being said, usually around 3 weeks, you will be cleared to slowly increase activities and lift lighter objects.
Depending on your type of work, you may actually be able to return within a week after surgery if you take special precautions.
By three months in, the fusion should be solid and the spine, stable. In fact, your spine should keep getting stronger for about a year. Usually by three months, however, you are cleared for many of the activities you enjoy.
In most cases, physical therapy is advised as part of your rehabilitation process. Physical therapy usually starts a few weeks after surgery. During physical therapy sessions, you will perform exercises to strengthen the neck and back muscles. In addition, you will develop activity modifications for your job or leisure activities that may prevent future injuries.
Physical therapy usually lasts 2 to 3 months, but this will vary depending on your progress.
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In most cases, herniated disc and/or bone spurs symptoms are first managed with conservative treatments. If the pain persists, however, you may want to consider ACD surgery.
To know if you qualify for an anterior cervical discectomy, you must first obtain an accurate diagnosis from your doctor or a spine specialist. This can include diagnostic imaging like X-rays, an MRI, CT scan, or myelogram to determine the location and severity of your damaged disc.
Certain neurological symptoms or treatment outcomes may make you a better candidate for ACD surgery. These include:
Keep in mind: Most people can manage their neck pain with a regimen of conservative treatments.
So what is your best treatment option?
Enlisting a team of professionals who will work together to develop a comprehensive treatment plan for you. NJ Spine & Orthopedic believes that most patients will benefit from conservative treatment options. And, where surgery is indicated, we strive to provide you with only the finest advancements in minimally invasive technology.
To schedule a consultation with our team of specialists, call (855) 586-2615 today. We are excited to hear your story and identify the best ways that we can help you!
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