I am thinking about having a neck surgery that involves taking out a bad disc and fusing the spine there. I asked my surgeon to have someone call me who has had the surgery, so I can get an idea of how safe this procedure is. So far, no one has called me. What can you tell me about the safety of this surgery?
It sounds like you might be planning to have an anterior cervical discectomy and fusion otherwise known as an ACDF. In this procedure, the surgeon comes in from the front of the neck (anterior) and removes the disc (discectomy).
Then the two vertebrae (one above the disc and one below the disc) are held together (fused) with a metal plate and screws (also called pins). The procedure is usually done at one spinal level but it can be done on more than one level, a process called multi-level fusion.
The ACDF procedure has been around since the 1950s. Many studies have been done to look at results and improve outcomes. The technique isn't perfect or always 100 per cent successful but for the most part, it does the job. The major disadvantage to cervical fusion is the loss of motion.
Two other potential complications of cervical fusion include the development of ossification (bone formation in the soft tissues) and adjacent disc disease. Adjacent disc disease refers to the degeneration of the disc above or below the disc already removed.
As a result of the disadvantages and potential problems that could develop with arthrodesis, many surgeons are going with disc replacements now. The early results of this procedure are fairly favorable. Ossification can still develop but seems to be an much less of a problem after disc replacement when compared with disc fusion.
The disc replacement preserves motion and may decrease the incidence of adjacent disc degeneration. Many studies are underway to examine and compare the features of disc removal and spinal fusion versus disc replacement. Studies show that in the hands of an experienced surgeon who performs many of these procedures, the anterior cervical discectomy and fusion (ACDF) is quite safe and very effective.