A cervical disc herniation can be removed through an anterior approach to relieve spinal cord or nerve root pressure and alleviate corresponding pain, weakness, numbness and tingling.
This procedure is called an anterior cervical discectomy and allows the offending disc to be surgically removed. A discectomy is a form of surgical decompression, so the procedure may also be called an anterior cervical decompression. A fusion surgery is almost always done at the same time as the discectomy in order to stabilize the cervical segment. This relieves pain associated with abnormal movement of the bones, all through a small incision in the front of the neck.
Together, the combined surgery is commonly referred to as an ACDF surgery, which stands for Anterior Cervical Discectomy and Fusion.
While this surgery is most commonly done to treat a symptomatic cervical herniated disc, it may be done for cervical degenerative disc disease. It may also be done for more than one level of the cervical spine.
The anterior approach of this surgery, which means that the surgery is done through the front of the neck as opposed to the back of the neck, has several typical advantages, including better access to the spine. The anterior approach can provide access to almost the entire cervical spine, from the C2 segment at the top of the neck down to the cervico-thoracic junction, which is where the cervical spine joins with the upper spine.
Another benefit is less postoperative pain. Spine surgeons often prefer this approach because it provides good access to the spine through a relatively uncomplicated pathway. All things being equal, the patient tends to have less incisional pain from this approach than from a posterior operation.
After a skin incision is made in the front of the neck, only one thin vestigial muscle needs to be cut, after which anatomic planes can be followed right down to the spine. The limited amount of muscle division or dissection helps to limit postoperative pain following the spine surgery.
While there are a number of potential risks and complications with ACDF surgery, the main postoperative problem most patients face is difficulty swallowing for two to five days due to retraction of the esophagus during the surgery.