Anterior Cervical Procedures
Anterior cervical procedures are spine surgeries performed through a small incision on the left front park of the neck in a skin line or crease. This is one of the most common procedures I perform. This a safe, less painful, and effective way to treat almost all pathology in the cervical spine.
The advantages of performing spine surgery through the front of the neck include:
- Direct access to most of the spine: Entering through a small incision on the front of the neck allows the surgeon to access almost the entire cervical spine, from the C2 segment all the way down to the cervicothoracic junction.
- Direct access to discs: Many cervical spine issues involve the cervical discs, which are found on the interior side of the spine. Entering through the front allows for direct visual access to the discs.
- Reduced postoperative pain: Entering through the front provides an easier pathway for the surgeon to perform the needed repairs. With an anterior approach, the surgeon typically only needs to move smaller muscles to the side, which limits the amount of pain patients experience during recovery. Post operative recovery from an ACDF is much faster and much less painful for patients. Many patients can actually go home on the day of surgery with little to no discomfort.
Cervical procedures that usually involve an anterior approach include:
- Anterior cervical discectomy and fusion (ACDF): Surgical removal of a herniated or degenerative disc followed by the placement of a bone graft and/or implants to stabilize and fuse the vertebrae together
- Cervical disc replacement: Surgical removal of a herniated or degenerative disc followed by the insertion of an artificial disc
- Anterior cervical corpectomy and fusion: Surgical removal of a herniated or degenerative disc as well as the majority of a vertebral body in which there is multi-level compression, bone spurs, or herniations. This surgery is done in cases of severe spinal cord compression or deformity.
- Cervical stenosis surgery (cervical spine canal decompression): Surgical decompression of the spinal cord through the removal of damaged or degenerative discs (ACDF or cervical disc replacement), small portions of arthritic bone or bone spurs, and alignment and decompression of enlarged facet joints causing nerve and neck pain.
Anterior cervical procedures begin with the following:
- The surgery is typically performed under general anesthesia and generally lasts less than two hours. Due to our efficiency and technique with this surgery, single level procedures can last as little as 30-45 minutes.
- A small incision (1 to 2 inches) is placed on the left front side of your neck. This is placed in a skin line or crease to allow for cosmetic closure.
- The spine is exposed through a small window of a naturally occurring muscle plane to allow for visualization of the disc space.
- The surgeon performs the needed repairs to the spine using a high powered microscope and live x-ray imaging for guidance and visualization. Using a microscope increases visualization and safety for the patient.
- The spinal cord and nerves are monitored during the procedure for real-time safety and feedback.
- The anterior incision is closed with all sutures under the skin, and a small dressing is applied.
- Recovery in the hospital will be carefully monitored before you are discharged home.
The details of your specific procedure (disc replacement, fusion, spinal canal decompression, etc.) will depend on the procedure you undergo.
As with all surgeries, anterior cervical procedures carry some risks. It is important to note that the anterior approach minimizes some risks, most notably postoperative pain. Some potential risks of anterior cervical procedures include:
- Reactions to anesthesia
- Temporary Hoarseness/voice change
- Temporary discomfort with swallowing
- The risks of nerve or spinal cord injury are incredibly low with modern techniques as well as constant real-time monitoring of patient’s nerves and spinal cord.
These and any other potential risks with be discussed with you in detail along with the potential benefits of your procedure when you are evaluated in clinic.