Anterior Cervical Discectomy and Fusion

It has been recommended that my wife have this surgery. We are both nervous about any kind of spinal surgery. Though the probabilities are with you, it is not impossible for things to go really bad. Anyone in Straightdopeland have any experience with this?

Is this having your neck bones fused? My dad had that done, a while ago maybe 10 years now?

He swears he can feel the plate when he swallows.

I can’t attest to how he feels having had it as opposed to how he felt before it. He’s got all sorts of muscle and nerve issues. But, he moves around just fine and he didn’t get paralyzed or anything.

I don’t remember any major complications while he was recovering. He had to wear a neck brace for a long while, and my mom did make sure someone was with him 24/7 for a bit, in case of emergency (so I had to go hang out with him while she was at work). I forget what the emergencies might have been…I think really just helping him in and out of bed.

Yes, it is fusion. Are your dad’s issues the result of this surgery?

I don’t think so. I am almost positive he’d be worse without surgery. His issues are the result of a life lived hard.

My wife has had two spinal fusion surgeries, but on the opposite end of the spine. The first was the bottom 4-5 levels of the lumbosacral region of the spine, and the second was the next 4 levels up in the thoracic region of the spine.

Both surgeries were completely successful, but the recovery was very difficult in both cases. She was in the hospital each time for about 4-5 days, followed by rehab in a skilled nursing facility for a week, followed by about 6 weeks of recovery at home before she could go back to work on a part-time basis (working at a desk job at home).

Even with all that fusion, it hasn’t really affected her moving around. In fact, with the relief from the pain she’d been having, she’s much more mobile than she was before.

One apparently common side effect of a fusion surgery is that the disc damage can progress further up or down the spine after a fusion, which is why my wife had a second fusion surgery three years after the first.

Adjacent Level Degeneration is the real drawback. Consider you’ve got seven vertebrae and eight joints in your neck, and together they manage the full range of motion of your head. Now lock up one or two of those joints in a fusion and you’re asking the other joints, especially the ones adjacent to the fusion, to pick up the slack. Stuff wears out faster. That’s bad, but what you have to keep in mind is that needing the surgery is usually the worse condition. Leave the blown disc alone and it will most likely continue to get worse, and continue to press on the nerve roots eventually causing damage. Pretty much all the sensation and muscle control in your arms/hands is controlled by the nerve roots coming off your spinal column. Ignore the problem and you can traumatize the roots so badly that you have permanent numbness and loss of use of all or part of the arm. Like a root canal, the surgery may not be a lot of fun, but needing it is worse.

Fairly new tech & procedures are ushering in disc replacement as an alternative to fusion. I’m not sure what the long term effects are of that, but in concept at least it doesn’t rob you of mobility, and thus is less harmful to the adjacent discs.


I strongly suggest getting multiple (2nd, 3rd, 4th) medical opinions about the advisability of this procedure and any alternative approaches, especially any that don’t close off the possibility of doing this one anyway if the alternative approach doesn’t work.

I’m under the impression – based on anecdotal evidence only, but I’ve known a double handful of people who have received spinal surgery – that this is a type of surgery that hasn’t yet come of age as something we really know how to do well. Because it is only anecdotal experience, I want to stress that you should not assume I am correct about this. But you and she should investigate. In particular, I suggest talking to as many people who have had it done as you can manage.

I have no experience at all with this surgery.

I just had a thought, that there should be a database similar to Home Adviser with a list of doctors and their surgery specialty and patient’s reviews. Patients who have had the surgery should be available to interview.

Yeah, yeah, I know… it was just a thought.

A friend had cervical vertebral fusion done about 12 years ago. The first few days were hell. The first six months were just a bit better. It took at least a year before he felt real improvement, and today he is happy that he had the surgery.

This. Unless you find an ortho who has a better idea for getting a blown disc off a nerve root, the options to the surgery are progressively worse radicular symptoms and paralysis of all or part of the limb. If that doesn’t sound like your idea of a good time, then it’s time for a fusion. It’s a major orthopedic surgery, not a wine tasting–it’s going to suck, but less than not doing it.

Is an artificial disk replacement an option for her? I’ve had four spinal surgeries so far, and I’ve got an artificial disk at C5-6. What level is affected for your wife?

What are the indications that an ACDF (fusion) is needed? Has her condition exceeded what can be managed with a microdiskectomy? Has she seen a neurosurgeon?

All four of my surgeries were done by neurosurgeons - I’ve never gotten a comfy vibe from orthos with regard to spinal surgeries, even down to their terminology. I’ve had orthopedic surgeons say “I’ll cut out the bad part, then you’ll feel great!” but the neurosurgeon I went with said more like “I’ll gently move the muscles out of the way to get at the disk, then carefully trim away the damaged part of the disk that is touching the nerve. You’ll probably have some residual pain for a few months while you heal.”

I got the artificial disk put in eight years ago, and so far, so good. My C6-7 was autofused, so for as long as it’s able to move as designed, the artificial disk is helping to keep C4-5 from being wrecked by adjacent segment disease.