From the Guidelines
Anterior Cervical Discectomy and Fusion (ACDF) at C5-C7 is a surgical procedure that involves removing damaged discs between the fifth and seventh cervical vertebrae from the front of the neck, relieving pressure on compressed nerves or spinal cord, and then fusing the vertebrae together for stability. This operation is commonly performed to address conditions like herniated discs, degenerative disc disease, or spinal stenosis that cause neck pain, arm pain, numbness, weakness, or neurological problems 1. The procedure typically involves making a small incision in the front of the neck, carefully moving aside muscles and other tissues, removing the problematic discs, and placing a bone graft or implant in the empty disc spaces. Metal plates and screws are typically used to provide immediate stability while the fusion develops over several months. Some key points to consider about ACDF at C5-C7 include:
- The use of multidetector CT scanning with high-quality multiplanar reformatted images can enhance the efficacy of CT assessment and imaging findings, particularly around hardware 1.
- CT is the most sensitive and specific modality to assess spinal fusion and can aid in detecting adjacent segment degeneration 1.
- Recovery from ACDF at C5-C7 typically takes 4-6 weeks for initial healing, though complete fusion may take 6-12 months.
- Patients usually experience significant pain relief and improved function, though some neck mobility may be reduced due to the fusion of these two segments. It's worth noting that recent advances in dual-energy CT have shown promise to reduce beam-hardening metal artifact, which may improve the evaluation of hardware complications and adjacent segment degeneration in postoperative patients with new or worsening neck pain 1.
From the Research
Definition of ACDF
- Anterior Cervical Discectomy and Fusion (ACDF) is a surgical procedure that involves the removal of disc material to achieve neural tissue decompression and placement of a bone graft or interbody implant and a cervical plate and screws to stabilize the spinal column at one or more vertebral levels 2.
ACDF at C5-C7
- ACDF at C5-C7 refers to the removal of the disc material between the C5 and C6 vertebrae and between the C6 and C7 vertebrae, and the fusion of these vertebrae using a bone graft or interbody implant and a cervical plate and screws 2, 3.
- This procedure is used to treat cervical degenerative disc disease, which can cause symptoms such as pain, numbness, and tingling in the neck and arms 4, 2.
Surgical Procedure
- The surgical procedure for ACDF at C5-C7 typically involves a transverse incision in the neck, and the use of microsurgical techniques to decompress the spinal cord and remove the disc material 3.
- A bone graft or interbody implant is then placed between the vertebrae to promote fusion, and a cervical plate and screws are used to stabilize the spinal column 2, 3.
Outcomes and Complications
- The outcomes of ACDF at C5-C7 can be successful, with improvement in symptoms such as pain, numbness, and tingling 2, 5.
- However, complications can occur, such as dysphagia, hardware failure, residual neck pain, and new-onset weakness 5.
- The radiographic fusion rate for ACDF at C5-C7 can be high, with one study reporting a fusion rate of 95% 5.