If your doctor has recommended surgery to address a problem in your neck or cervical spine, you may be considering a procedure known as Anterior Cervical Discectomy and Arthroplasty (ACDA). This surgery is designed to treat conditions such as cervical disc herniation, degenerative disc disease, or spinal stenosis, which can cause neck pain, radiating arm pain, and other neurological symptoms like numbness or weakness.
ACDA is an alternative to the more traditional Anterior Cervical Discectomy and Fusion (ACDF). While both procedures share similarities, ACDA involves the removal of a damaged disc followed by the implantation of a disc prosthesis (artificial disc) instead of fusing the vertebrae together. In this patient education guide, we’ll explore what ACDA is, its benefits, potential risks, the surgical procedure, and recovery expectations to help you make an informed decision about your treatment.
At Endoscopic & Minimally Invasive Spine Specialists, we have extensive experience and expertise in anterior cervical discectomy and fusion as well as anterior cervical discectomy with arthroplasty, and provide the highest-quality care in surgical and non-surgical spine care.
To learn more about anterior cervical spine surgery, call the office today or request an appointment online.
What is Anterior Cervical Discectomy and Arthroplasty (ACDA)?
Anterior Cervical Discectomy and Arthroplasty (ACDA) is a surgical procedure designed to treat problems with the cervical spine, which is the part of the spine that runs through the neck. The procedure involves two main components:
- Discectomy: This refers to the removal of a damaged or herniated intervertebral disc. The disc is a cushion-like structure between the vertebrae that can degenerate or bulge out, putting pressure on the spinal cord or nerves, causing pain, numbness, weakness, or other neurological issues.
- Arthroplasty: After the damaged disc is removed, an artificial disc (prosthesis) is implanted to replace the removed disc and preserve motion at the affected level of the cervical spine. This allows the spine to retain more natural motion and flexibility compared to fusion surgery, which permanently joins two vertebrae together.
Conditions Treated with ACDA
ACDA is typically used to treat conditions that affect the cervical spine, including:
- Cervical Disc Herniation: When the soft inner portion of a cervical disc bulges out and presses on a nerve or the spinal cord, causing pain, weakness, or numbness in the neck, arms, or hands.
- Degenerative Disc Disease: Over time, discs in the cervical spine can break down due to wear and tear. This can lead to reduced disc height, instability, and nerve compression, causing pain and other symptoms.
- Spinal Stenosis: Narrowing of the spinal canal that can compress the spinal cord or nerve roots.
- Cervical Spondylosis: A general term for age-related changes in the spine, such as bone spurs or degenerating discs, which can cause similar symptoms to those of herniated discs.
If conservative treatments such as physical therapy, medications, or injections have not relieved your symptoms, ACDA may be recommended to address the underlying cause and improve your quality of life.
Benefits of ACDA
One of the main advantages of anterior cervical discectomy and arthroplasty (ACDA) over fusion procedures is that it preserves the motion of the cervical spine. This can lead to:
- Preserved Range of Motion: Unlike fusion surgery, which locks the vertebrae together, ACDA allows for continued movement at the operated level. This means the spine retains its natural flexibility and function, which can help avoid stiffness and discomfort in the neck and reduce the likelihood of adjacent segment disease (problems developing in the discs or joints above or below the fusion site).
- Quicker Recovery: Some studies suggest that patients who undergo ACDA may experience a faster recovery time compared to those who undergo fusion, especially in terms of neck mobility and overall function.
- Reduced Risk of Adjacent Segment Disease: Fusing vertebrae together can place additional stress on the neighboring vertebrae, increasing the risk of degeneration in those areas over time. Because ACDA preserves motion, it may reduce this risk.
Risks and Complications
Although ACDA is a safe and effective procedure for many patients, like all surgeries, it comes with some risks. These include:
- Infection: As with any surgery, there is a risk of infection at the incision site or in the surgical area.
- Nerve Injury: There is a small risk of nerve damage during the procedure, which could result in new or worsening symptoms such as numbness, weakness, or pain.
- Implant Failure: In rare cases, the artificial disc may become displaced, break, or wear out prematurely, necessitating revision surgery.
- Allergic Reaction to Materials: Although rare, some patients may experience an allergic reaction to the materials used in the artificial disc (e.g., metal or plastic).
- Failed Surgery: While ACDA is generally effective, there is a possibility that symptoms may not improve, or they may recur over time, potentially requiring additional interventions.
- Swallowing or Breathing Difficulties: Since the procedure is performed through the front of the neck, there may be temporary difficulty swallowing (dysphagia) or mild hoarseness in the days following the surgery. These issues are usually short-lived.
The ACDA Procedure
The ACDA procedure is performed under general anesthesia, meaning you will be asleep and pain-free during the surgery. Here is an overview of what to expect during the procedure:
- Incision: The surgeon makes a small incision in the front of your neck. This is the most common approach for cervical spine surgeries, as it provides direct access to the affected disc while avoiding disruption to the muscles and nerves in the back of the neck.
- Discectomy: The surgeon carefully removes the damaged or herniated disc, taking care to preserve the surrounding structures, including the spinal cord and nerve roots.
- Implantation of the Artificial Disc: After the disc is removed, the surgeon places an artificial disc (prosthesis) into the disc space. The artificial disc is designed to mimic the function and movement of a natural cervical disc. It is typically made from materials such as titanium, plastic, or a combination of both. The disc is secured in place with the goal of restoring normal disc height and maintaining motion at that level.
- Closure: After the artificial disc is implanted, the incision is closed using sutures beneath the skin and surgical glue. A dressing is applied to the surgical site.
Recovery After ACDA
Recovery from ACDA varies from patient to patient, but most people experience significant improvement in their symptoms within a few weeks to months. Here’s what you can expect during your recovery:
1. Post-Operative Stay: Most patients stay in the facility for 3-6 hours following the procedure. Rarely will it be necessary for a patient to stay overnight. The length of your stay will depend on how you are feeling after the surgery and your doctor’s recommendations.
2. Pain Management: Pain is common following surgery, but your surgeon will prescribe pain medications to help manage discomfort. Most patients experience mild to moderate pain or soreness in the neck and throat area, which typically improves within the first few days to weeks.
3. Neck Collar: Some surgeons recommend wearing a soft neck collar for a short period after surgery to support the neck during the early stages of healing. Typically, our surgeons do not recommend collars after disc replacement surgery, and encourage early neck mobilization.
4. Physical Therapy: Physical therapy may begin soon after surgery to help restore strength and range of motion in the neck. Exercises will typically be gradual, starting with gentle movements and progressing as your healing progresses.
5. Follow-up Appointments: You will have regular follow-up appointments with your surgeon to monitor your progress. X-rays or other imaging tests may be performed to ensure the artificial disc is in place and that healing is progressing.
6. Activity Restrictions: During the first several weeks following surgery, you will be advised to avoid strenuous activities that could stress the neck, such as heavy lifting, bending, or twisting motions. Your surgeon will give you specific guidelines on when you can resume normal activities.
7. Full Recovery: Full recovery from ACDA can take several weeks to months. The artificial disc will help restore motion, but it can take time for the muscles and tissues to fully heal around the implant. Most patients return to normal activities within 6 weeks, but this timeline can vary.
Long-Term Outlook
Most patients who undergo ACDA report significant improvements in their symptoms, including pain relief and restored function. However, the long-term success of the procedure depends on several factors, including the patient’s overall health, adherence to post-surgery instructions, and whether any complications arise.
It is important to maintain a healthy lifestyle, including good posture, proper ergonomics, good diet and regular exercise to help protect your spine and maintain the benefits of the surgery.
Contact EMISS to Schedule Your Procedure
Anterior Cervical Discectomy and Arthroplasty (ACDA) is an effective surgical option for patients with cervical spine issues, offering benefits such as preserved motion and reduced risk of adjacent segment disease. Although the surgery comes with some risks, it can provide long-lasting relief for many patients who have not responded to conservative treatments.
If you are considering ACDA, it’s important to discuss the procedure thoroughly with your surgeon, understand the risks and benefits, and follow all postoperative care instructions to ensure the best possible outcome. With proper care and rehabilitation, ACDA can significantly improve your quality of life and help you return to your daily activities.
To learn how you can benefit from anterior cervical discectomy and fusion or arthroplasty and patient-centered care your spinal problems, call Endoscopic & Minimally Invasive Spine Specialists today, or book an appointment online.
