Anterior Cervical Discectomy and Fusion (ACDF)
ACDF is the most commonly performed procedure to treat cervical radiculopathy. The procedure involves removing the problematic disc or bone spurs and then stabilizing the spine through spinal fusion.
The goals of ACDF are to:
- Restore alignment of the spine
- Maintain the space available for the nerve roots to leave the spine
- Limit motion across the degenerated segment of the spine
Procedure. An “anterior” approach means that the doctor will approach your neck from the front. He or she will operate through a 1- to 2-inch incision along the neck crease. The exact location and length of your incision may vary depending on your specific condition.
During the procedure, your doctor will remove the problematic disc and any additional bone spurs, if necessary. The disc space is restored to the height it was prior to the disc wearing out. This makes more room for the nerves to leave the spine and aids in decompression.
Artificial Disc Replacement (ADR)
This procedure involves removing the degenerated disc and replacing it with artificial parts, as is done in hip or knee replacement. The goal of disc replacement is to allow the spinal segment to keep some flexibility and maintain more normal motion.
Similar to ACDF, your doctor will use an “anterior” approach for the surgery—making a 1- to 2-inch incision along the neck crease. The exact location and length of your incision may vary depending on your specific condition.
During the surgery, your doctor will remove your problematic disc and then insert an artificial disc implant into the disc space. The implant is made of all metal or metal and plastic. It is designed to maintain the motion between the vertebrae after the degenerated disc has been removed. The implant may help restore the height between the vertebrae and widen the passageway for the nerve roots to exit the spinal canal.
Posterior Cervical Laminoforaminotomy
In posterior cervical laminoforaminotomy, the doctor uses specialized instruments to thin down the lamina to gain better access to the nerve.
“Posterior” refers to the back part of your body. In this procedure, the doctor will make a 1- to 2-inch incision along the midline of the back of the neck. The exact location and size of your scar may vary depending on your condition.
During a posterior cervical laminoforaminotomy, the doctor uses a burr and other specialized tools to thin down the lamina—the bony arch that forms the backside of the spinal canal. Removing this allows the doctor better access to the damaged nerve.
He or she then removes the bone, bone spurs, and tissues that are compressing the nerve root. If your compression is due to a herniated disc, your doctor will remove the portion of the disc that is compressing the nerve, as well.