Performing World Class Procedures

Anterior Cervical Disectomy & Fusion (ACDF)

Anterior cervical discectomy and fusion (ACDF) is a surgery to remove a herniated or degenerative disc in the neck. An incision is made  on the anterior side (throat area) of the neck to reach and remove the disc. An interbody spacer is inserted to help fuse together the bones above and below the disc space. ACDF surgery may be an option if physical therapy or medications fail to relieve your neck or arm pain caused by pinched nerves. Patients typically go home the same day.

Figure 1. (top view of vertebra) Degenerative disc disease causes the discs (purple) to dry out. Tears in the disc annulus can allow the gel-filled nucleus material to escape and compress the spinal cord causing numbness and weakness. Bone spurs may develop which can lead to a narrowing of the nerve root canal (foraminal stenosis). The pinched spinal nerve becomes swollen and painful.

After the degenerated or herniated disc is removed, the space between the bony vertebrae is empty. To prevent the vertebrae from collapsing and rubbing together, an interbody spacer is inserted to fill the open disc space. The spacer serves as a bridge between the two vertebrae to create a spinal fusion. To facilitate fusion, the spacer may also be packed with a bone graft such as autograft (your own bone), cellular allograft (cadaver bone that contains stem cells), or a ceramic bone graft substitute (man-made plastic, ceramic or resorbable compounds).  The spacer and adjacent vertebrae are fixed in place with metal plates and screws. Following surgery the body begins its natural healing process and new bone cells grow through and around the spacer. After 3 to 6 months, the new bone should join the two vertebrae and form one solid piece of bone. The metal plates and screws and fused spine segment work together, similar to reinforced concrete.

Anterior Lumbar Interbody Fusion (ALIF)

Anterior lumbar interbody fusion (ALIF) is a surgery to remove a herniated or degenerative disc in the lower spine. 

Although most spinal surgeries are performed using a posterior (back) approach, your surgeon may choose an anterior (front) approach for a number of reasons, including:

• To avoid multiple surgeries in one area if you have already had previous spinal surgeries using a posterior (back) approach.
• To allow more direct access to the intervertebral disck.
• To have the ability to add more lordosis (swayback) to your spine.
• Your recovery may be quicker.

In contrast to a posterior approach to low back surgery, when your surgeon uses an anterior approach he or she can access your spine without moving the nerves. Organs and blood vessels must be moved to the side with an anterior approach, however. In most cases, a vascular surgeon assists the orthopaedic surgeon with opening and exposing the disc space.

In an anterior lumbar interbody fusion, the intervertebral disc between two lumbar vertebraek is removed. After the degenerated or herniated disc is removed, the space between the bony vertebrae is empty. To prevent the vertebrae from collapsing and rubbing together, an interbody spacer is inserted to fill the open disc space. The spacer serves as a bridge between the two vertebrae to create a spinal fusion. To facilitate fusion, the spacer may also be packed with a bone graft such as autograft (your own bone), cellular allograft (cadaver bone that contains stem cells), or a ceramic bone graft substitute (man-made plastic, ceramic or resorbable compounds).  The spacer and adjacent vertebrae are fixed in place with metal plates and screws. In ALIF surgery, some interbody fusion implants are called stand-alone devices, incorporating the benefits of the spacer and plates into a single implant. Following surgery the body begins its natural healing process and new bone cells grow through and around the spacer. Over time, the new bone should join the two vertebrae and form one solid piece of bone. The metal plates and screws and fused spine segment work together, similar to reinforced concrete.