Anterior Cervical Discectomy and Fusion

Anterior cervical discectomy and fusion is the most common procedure for cervical radiculopathy. Radiculopathy is a description of a problem in which one or more nerves are affected and do not work properly. It restores alignment of the spine, maintains the space available for the nerve roots to leave the spine, and limits motion across the degenerated spine segment.

Discectomy

One of the most common surgical procedures for problems in the cervical spine is an anterior cervical discectomy. The term “discectomy” means to “remove the disc”. A discectomy relieves the pressure on a nerve root by removing the herniated disc causing the pressure on the nerve root.

In the cervical spine, the disc is usually removed from the front. An incision is made in the front of your neck right beside your trachea (windpipe). The muscles are moved to the side. The arteries and nerves in the neck are protected as well.

Once the spine is reached from the front, each disc and vertebrae are identified using an X-ray to make sure that the right disc is being removed. Once this is determined, the disc is removed all the way back to the spinal cord. Any bone spurs that are found sticking off the back of the vertebra are removed as well. Great care is taken to not damage the spinal cord and nerve roots.

In the cervical spine, a discectomy is usually combined with a spine fusion where the two vertebrae on either side of the disc that has been removed, are allowed to heal together, or fuse.

Anterior Cervical Fusion

Once the disc has been removed between the vertebrae, a cervical fusion is performed. This procedure allows the surgeon to fill space left by removing the disc with a block of bone taken from the pelvis. Placing a bone graft between two or more vertebrae causes the vertebrae to grow together, or fuse.

The bone graft is usually taken from the pelvis at the time of surgery, but some surgeons prefer to use bone graft obtained from a bone bank. Bone graft from a bone bank is taken from organ donors and stored under sterile conditions until needed for operations such as spinal fusion. The bone goes through a rigorous testing procedure, similar to a blood transfusion. This is in order to reduce the risk of passing on diseases to the recipient.

The Goal

The goal is to lessen pain by limiting painful motion between vertebrae. A metal plate and screws are commonly used along the front of the cervical spine. They provide stability and help increase the rate of fusion. Bone graft is used to fill in the space left after the disc is removed. It is primarily used to stimulate bone healing and help the vertebrae to fuse together into a solid bone. A bone graft can be obtained from the patient’s hip. This type of graft is called an autograft. Harvesting a bone graft requires an additional incision along the hip and lengthens surgical time. Although autografts have been used with good results, some people may experience pain at the hip for some time. One alternative to harvesting a bone graft is an allograft, which is cadaver bone. An allograft is typically acquired through a bone bank. The use of allograft has grown because it avoids the risk of pain at the donor site. There are risks and benefits for both types of bone grafts, which your surgeon will discuss with you.

Conditions Treated by Anterior Cervical Discectomy and Fusion

Spinal Stenosis

Symptoms Treated by Anterior Cervical Discectomy and Fusion

Claudication in the legs
Low back pain
Neck pain

Service Providers

Henry Small, M.D.

Dr. Small is a board certified orthopedic surgeon. He has 23 years of experience.

Vivek P. Kushwaha, M.D.

Dr. Kushwaha has been honored with the Memorial Hermann Hospital Award for “Most Efficient Surgeon” and was commended as one of “America’s Top Physicians” by The Consumer Research Council of America.