What is Anterior Cervical Discectomy?
There are three main types of anterior cervical discectomy surgeries. Anterior cervical discectomy (ACD) is a surgical procedure that involves removing a part or all of a damaged spinal disc through an incision in the neck.
- ACDdoes not involve placement of a bone graft.
- Anterior cervical discectomy and fusion (ACDF)is similar to ACD, but it does involve placement of a bone graft.
- The anterior cervical discectomy and fusion with instrumentation (ACDFI)technique is similar to ACDF but additionally involves the placement of a plate to help stabilize the cervical spine.
Indications for each different type of surgery should be discussed with a spinal surgeon depending on the type, location, and severity of the disc injury.
What is Anterior Cervical Discectomy Used For?
颈椎前路椎间盘摘除(ACD)前cervical discectomy and fusion (ACDF), and anterior cervical discectomy and fusion with instrumentation (ACDFI) are all used to treat:
- chronic cervical spineosteoarthritis,
- cervical spinetrauma,
- radiculopathy,
- cervical discherniations,
- myelopathy,
- osteomyelitis,
- spondylosis,
- vertebral body tumors, and
- post-laminectomykyphosis.
How Do Doctors Perform Anterior Cervical Discectomy?
Anterior cervical discectomy is performed under general anesthesia. For all three types of anterior cervical discectomy procedures:
- 患者放置躺在他们的背上their head extended
- Hands may be tied down to allow for easier access to the neck
- The area of the neck and chest are prepped with antiseptics
- An incision is made in the front of the neck, and the muscles and subcutaneous layers are carefully separated
- Deeper structures such as blood vessels, nerves, theairway, andesophagusare also carefully moved
- Once the damaged disc is located, it is removed
- If an ACDF or ACDFI procedure is being performed, a bone graft and/or hardware is placed
- Deep structures are moved back into normal position
- The incision is sutured closed
- After surgery, a cervical collar may be worn for up to 6 weeks
X-raysmay be performed at follow-up intervals. If there are any complications from the surgery, aCT scanorMRImay be needed.
SLIDESHOW
Back Pain: 16 Back Pain Truths and MythsSee SlideshowWhat are Risks and Complications of Anterior Cervical Discectomy?
Prior to surgery, the surgeon will assess the risks for complications. Risk factors that can lead to increased complications include:
- Advanced age
- Smoking
- Lowbone density(osteoporosis)
- Obesity
- Sleep apnea
- Carotid artery disease
Complications of anterior cervical discectomy include:
- Infection of surgicalwound
- Infection of bone graft or around hardware
- Spinal cord injury
- Nerve root injury resulting inweakness
- Tears in the tissue around the spinal cord (dural tears)
- Cerebrospinal fluid leaks
- Hardware complications
- Screw loosening or breakage
- Plate breakage
- Plate movement
- Graft failure
- Neck-related complications due to frontal approach
- Damage to esophagus
- Problems swallowing
- Neck bleeding
- Airway complications and obstruction
References
Medscape Medical Reference
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