The Anterior Cervical Discectomy & Fusion Procedure
Anterior cervical discectomy and fusion is our classical treatment for disc herniation or bone spur with pressure on the nerve root causing radiculopathy or nerve pain extending into the shoulder and arm.
This procedure is performed from the front of the neck through a small incision. The anterior approach is preferred because a direct decompression of the spinal cord and nerve roots can be done with no Manipulation of the spinal cord with excellent visualization of the nervous elements. The disc is exposed and microscopically the central portion of the disc is removed to the back of the disc space and gradually the disc herniation and any bone spur are removed that are pressing on the spinal cord and nerve roots. Once the central portion of the disc is removed there is a gap or space left that should be filled to prevent future collapse of the disc space. This space can be filled with one of two things, a fusion cage or box filled with bone graft, or an artificial disc replacement.
A fusion is chosen when there is no motion of the disc space to preserve with an artificial disc and when multiple discs require treatment. The fusion cage is packed with bone chips and augmented with your own stem cells from the iliac crest bone marrow to enhance the fusion. Usually an anterior cervical plate is applied over the fusion cage to increase stability of the construct. Over a few months the bone from each vertebra grows into the bone graft forming a fusion across the disc space permanently stopping the motion of the disc. With the loss of motion comes pain relief that the motion of the disc caused.