There are two approaches to the cervical spine that a surgeon can adopt: a. An anterior or front approch, in the front of the neck; b. A posterior or back approch, along the back of the neck.
The anterior approach is preferred as there is less risk to central spinal cord damage. There is also the advantage of no incision through the intravertebral muscles that support the neck when upright. These muscles are thin and transervse spinal processes for short distances, sequentially linking one to another. They are not strong muscles and an anterior approach avoids disrupting their delicate balance and provides better post-surgical postural control of the head in upright.
A posterior approach is selected when specific findings on an MRI suggest need for more target posterior access of the cervical segments involved.
Your surgeon, in reviewing your imaging MRI studies or other (myleogram, x-rays), is selecting an anterior approach because he/she feels that the “work” to be done will not require a back access of the vertebrae. All intended “work” can be accomplished without flipping your over from front to back.
What type of “work” might your ACFD involve?
A. Trimming or complete removal of gelatinous disc material that has protruded or fully herniated outside of the ring of fibrous tissue that normally encapsulates a disc/disc material. A surgeon can trim or completely remove a disc/disc material from a frontal approach. A bone graft from another area of your body (hip or pelvis) or donated bone material is then placed in the disc space. Titanium screws or plates are then secured to stabilize the cervical levels involved to provide stability until full bone healing/fusion has occurred (8-12 months)
B. Bone spurs. Bone spurs are outgrowths or appendages of bone that form in result of irritation or micromovement between cervical vertebrae. Bone is a living tissue that is constantly breaking down and rebuilding. Bone spurs occur when bone building processes are in excess of bone remodeling/breakdown processes.
C. Irritated or inflamed ligamentous flavum. The ligamentous flavum wraps around the perimeter of a vertebrae like a band of kitchen food Saran Wrap. The ligament can become inflamed and cause pressure on either the disc material or exiting nerve roots. Trimming or removing the flavum can also be part of an ACDF.
Bottom Line: Your surgeon is using an anterior approaches based on your specific imaging studies and needs. He/she feels confident that your underlying surgical issues/needs that warrant surgery can be accessed from a front approach without having to use a back approach. The anterior approach is considered a less invasive and overall safer approach.
It sounds like you may want to talk with your surgeon to better know understand your imaging studies and exactly what “work” is intended to be done. It is always wise to fully understand any contemplated surgery so that you can beat prepared for recovery and expected/hoped for results. Everyone who has an ACDF or PCDF will have differences as to why they are undergoing the procedure.
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Post Edited ((Seashell)) : 12/30/2018 7:13:28 AM (GMT-7)