Arm and neck pain can have many causes, but when the discomfort is caused by problems in the spinal column, a procedure known as anterior cervical discectomy and fusion (ACDF) in Mission Viejo, CA, may be necessary. When discs in the upper (cervical) spine develop problems, nerves may become compressed or pinched, causing chronic discomfort. By removing the problem disc and stabilizing the spine with a fusion procedure, patients can improve their quality of life and reduce the need for pain medication.
Alexander Taghva, M.D., F.A.A.N.S., is a board-certified neurosurgeon specializing in spine surgery, including ACDF, in Orange County, CA. Patients can often undergo this complex surgery as an outpatient procedure and get quick relief from a bulging or herniated disc, bone spurs, and other problems in the cervical spine.
About the Spine
The spine is made up of a series of bones (vertebrae), discs, and facet joints. These components interlock and provide stability and flexibility for the body, as well as protection for the spinal cord, which delivers information from the brain to the body through the spinal nerves. There are three sections of the spine: cervical (upper, including the neck), thoracic (middle), and lumbar (lower back).
Each intervertebral disc, which rests between two vertebrae, is made up of two different parts. The outer material (annulus) is tough and fibrous, while the inner material (nucleus) is soft and gel-like. Spinal discs are essential for mobility and shock absorption, but they may become damaged over time due to an unbalanced pressure, poor posture, degenerative disc disease, or injury.
When discs become damaged, they may dry out and stiffen, causing them to bulge. Disc herniation occurs when a crack develops in the tough outer layer, causing the material inside the disc to leak out and cause irritation in the nerve roots. Slight damage to the discs can sometimes be fixed by removing a portion of a damaged disc, but other cases require total removal and fusion or replacement.
What is Anterior Cervical Discectomy and Fusion?
Dr. Alexander Taghva offers anterior cervical discectomy and fusion to Orange County patients experiencing neck and arm pain or numbness that is unresponsive to non-surgical treatments. ACDF surgery is performed to remove a damaged disc in the cervical spine and fuse the vertebrae.
Most patients notice significantly less pain once they have healed from anterior cervical discectomy and fusion in Mission Viejo, CA. Dr. Taghva customizes the procedure to meet each patient’s unique needs.
Candidates for ACDF in Orange County
ACDF surgery is a good option for some patients experiencing cervical spine issues, but it is not appropriate in every case. In general, Dr. Taghva will recommend less invasive treatment methods before resorting to surgical treatments. The only way to determine the best course of treatment is to schedule a consultation with Dr. Taghva.
Good candidates for anterior cervical discectomy and fusion at our Mission Viejo practice may include men and women who are suffering from one or more of the following problems in the cervical spine:
- Damaged disc or discs
- Compression of the nerve root
- Herniated disc
- Bulging disc
- Degenerative disc disease
- Spinal stenosis
- Bone spurs
Many of these problems can be solved or managed with non-surgical or minimally invasive surgery options. However, more advanced spine disorders may require spinal fusion or artificial disc replacement. If left untreated, compression of the nerves and spinal cord can cause serious damage or long-term pain.
Your Consultation in Mission Viejo, CA
Patients who are struggling with chronic neck and arm pain will need to discuss their symptoms and medical history with Dr. Taghva before scheduling an anterior cervical discectomy and fusion procedure at his Orange County office.
During the consultation, Dr. Taghva reviews the patient’s medical history and goes over any diagnostic images that the patient’s other doctors may have taken. He asks patients about their symptoms and may request that additional images or tests be performed before he makes a diagnosis and creates a custom treatment plan.
If Dr. Taghva believes that the patient is a good candidate for the ACDF procedure, he will explain the entire process, including the surgical techniques and anesthesia that will be used, the healing process, and the risks of the procedure. He will also invite the patient to ask any questions they may have. If he does not believe the patient is a good candidate, he may suggest non-surgical treatments or a different minimally invasive spine surgery instead.
Preparing for ACDF Surgery
Before cervical discectomy and fusion in Mission Viejo, patients will be given detailed instructions for pre- and post-operative care, which should be followed closely to reduce the risk of complications. Before the procedure, Dr. Taghva may order blood tests, an ECG (electrocardiogram), or x-rays to ensure that the patient is healthy enough for surgery. He may also request that certain medications be switched, paused, or adjusted for safety reasons.
Patients will need to stop smoking well in advance of the procedure—ideally several months before surgery. Nicotine hinders the healing process and can cause problems during the surgery itself, especially with the use of general anesthesia.
Anti-inflammatory drugs, both prescription and over-the-counter, should be avoided for about a week before the surgery. Patients should refrain from drinking alcohol for a week before the procedure and may need to stop taking some supplements as well. Dr. Taghva’s office provides each surgical patient with a comprehensive list of supplements and medications to avoid prior to surgery.
The night before the surgery, no food or drink should be consumed after midnight, as this can cause issues with the anesthesia. Patients should shower the morning of the surgery and wear comfortable, loose-fitting clothing, with no makeup or jewelry.
Finally, patients will need to have someone drive them to and from the procedure, as they will be given anesthesia and pain medications. It is best to have someone stay with the patient during the first few days to help them recover and perform basic tasks.
The Anterior Cervical Discectomy and Fusion Procedure
Dr. Alexander Taghva typically performs anterior cervical discectomy and fusion procedures in Orange County on an outpatient basis. During the procedure, patients are put under general anesthesia, but will usually be released on the same day.
ACDF is performed through the front of the neck, with the patient lying on their back. Once the anesthesia has been administered, Dr. Taghva makes a small incision (about 2 inches long) on one side of the neck. He then moves different structures in the neck to the side using a tubular reactor, including the muscles and trachea, so he can access the spinal column.
Once he has access to the discs of the cervical spine, Dr. Taghva locates the damaged disc and carefully removes it. He then removes or resolves any material that may be compressing the spinal nerves, such as a bone spur. The area where the spinal nerves exit may also be enlarged to relieve pressure.
Dr. Taghva will then prepare to fill in the disc space left behind by the discectomy. This may involve taking a bone graft and making another incision, often in the hip area. The two vertebrae that will surround the graft or spacer are prepared to receive it so that all three parts will fuse during healing.
Finally, a metal plate and screws may be placed to keep the graft in place during fusion and to add extra stability. The incision(s) are closed and the patient is taken into recovery. The procedure typically takes 1-3 hours to perform.
Recovering from ACDF
Many anterior cervical discectomy and fusion patients in Mission Viejo can go home on the day of the surgery and are often sitting and walking soon after the procedure. Some discomfort is to be expected but can be controlled with the help of pain medications. Patients may have a sore throat, hoarseness, or difficulty swallowing for some time after the surgery, due to the surgeon’s access point. This should resolve within a few weeks.
Patients should get plenty of rest after the procedure and may need to wear a soft neck brace for several weeks. They should avoid looking up or down and should not lift anything over 5 pounds. Light activity, such as walking, will help encourage healing. Physical therapy may also be recommended.
Strenuous exercise, driving, sex, swimming, and tub baths will need to be avoided until Dr. Taghva gives the all-clear. Patients will also need to avoid nicotine products and alcohol during recovery and must refrain from using NSAID medications for a minimum of six months.
Dr. Taghva provides patients with detailed instructions and information about restrictions. Several follow-up appointments will be scheduled to ensure that healing and fusion are progressing normally. Though full fusion can take a year to complete, most patients feel better within 4-6 weeks and are nearly back to normal within a few months.
Risks of ACDF in Orange County
Like all surgical procedures, ACDF at our Mission Viejo facility is associated with some risks. Dr. Taghva’s skill and experience limit the risks, but patients need to be aware of the potential complications and follow all pre- and post-operative care instructions carefully to prevent and detect any problems that should arise. Risks may include:
- Excessive bleeding
- Anesthesia complications
- Failed fusion
- Graft shifting/migration
- Persistent hoarseness/trouble swallowing
- Nerve damage
- Added wear on other vertebrae and discs
Why Choose Dr. Taghva for Your Anterior Cervical Discectomy and Fusion in Orange County?
Alexander Taghva, M.D., F.A.A.N.S., is a highly respected, board-certified neurosurgeon specializing in minimally invasive spine surgery, revision spinal surgery, spinal stenosis, herniated discs, chronic pain, and Parkinson’s disease. He is active in clinical research and uses several minimally invasive techniques to reduce surgical trauma and recovery times. Dr. Taghva is the only neurosurgeon in Orange County offering endoscopic spine surgery.
Known for his dedication to patient care and his customized approach, Dr. Taghva only recommends spinal fusion procedures like ACDF if he believes that less invasive options will be ineffective. His ultimate goal is sustainable spine health and patient comfort. To schedule a consultation with Dr. Alexander Taghva, call 949-388-7190.
Frequently Asked Questions About ACDF
While ACDF does remove an intervertebral disc and replaces it with an inflexible bone graft, most patients already have trouble with some activities even before undergoing surgery. While the surgery may technically reduce mobility, most patients, in turn, gain mobility and comfort because they are no longer suffering from chronic pain and numbness that limits comfortable movement.
ACDF involves removing a damaged cervical disc and replacing it with a bone graft or another spacer, while disc replacement involves removing the damaged disc and replacing it with an artificial disc to allow for improved mobility. Disc replacement is a better option than anterior cervical discectomy and fusion for some Orange County patients, but not for others. Dr. Taghva assesses each patient’s case and makes a recommendation based on their specific needs.
Spinal fusion is a procedure that is performed when a spinal disc is damaged beyond repair. The disc is removed to relieve pressure and resolve chronic pain. Then, a bone graft is placed in the disc space before it is screwed into place. Over a year or so, the bones fuse together and create a more stable, but less flexible, spine.
Many patients with herniated discs can find relief with non-surgical treatment. Dr. Taghva often recommends trying less invasive therapies before performing surgery. However, if the pain from a herniated disc lasts longer than 6 weeks, a minimally invasive spine procedure like anterior cervical discectomy and fusion may be the best option.