Tag Archives: Spinal

Anterior cervical discectomy and fusion(ACDF)

Anterior cervical discectomy and fusion (ACDF) is a surgical procedure to treat nerve root or spinal cord compression by decompressing the spinal cord and nerve roots of the cervical spine with a discectomy, followed by inter-vertebral fusion to stabilize the corresponding vertebrae.This procedure is used when other non-surgical treatments have failed.

Medical uses

ACDF is used to treat serious pain from a nerve root  that has become inflamed. This can be caused by:

1. a herniated disc when other non-surgical treatments have failed. The nucleus pulposus (the jelly-like center of the disc) of the herniated disc bulges out through the annulus (surrounding wall) and presses on the nerve root next to it.

2. degenerative disc disease (spondylosis). The disc consists of about 80% water. When one grows older, the disc starts to dry out and shrink, causing small tears in the annulus and inflammation of the nerve root.

 

Technique

Anterior cervical discectomy and fusion(ACDF) surgery

The neurosurgeon or orthopedic surgeon enters the space between two discs through a small incision in front (= anterior) of and at the right or left side of the neck. The disc is completely removed, as well as arthritic bone spurs. The disc material, pressing on the spinal nerve or spinal cord, is then completely removed. The intervertebral foramen, the bone channel through which the spinal nerve runs, is then enlarged with a drill giving the nerve more room to exit the spinal canal.

To prevent the vertebrae from collapsing and to increase stability, the open space is often filled with a graft. That can be a bone graft, taken from the pelvis or cadaveric bone; or an artificial implant. The slow process of the bone graft joining the vertebrae together is called “fusion”. Sometimes a titanium plate is screwed on the vertebrae or screws are used between the vertebrae to increase stability during fusion, especially when there is more than one disc involved.

Anterior cervical discectomy and fusion(ACDF)  surgery

 

Recovery

The surgery requires a short stay in the clinic (1 to 3 days) and a gradual recovery between 1 and 6 weeks. However, the technology has advanced and it can be performed by ‘Endoscopic Micro Discectomy” with the patient able to continue their normal life in two days. The patient may be advised to wear a neck brace or collar (for up to 8 weeks) that serves to ensure proper spinal alignment. Wearing the brace heightens one’s awareness of posture and positioning and helps prevent movements (e.g., sudden and/or excessive bending or twisting of the neck) that may aggravate or slow down the healing process.

It is especially advisable to wear a protective neck brace when traveling (e.g., by car), sleeping, showering, or any other activities in which the patient may not be able to be ensure proper spinal alignment. In addition, physical therapy and related healing modalities (e.g., massage, acupuncture) may be recommended in order to promote proper healing, as well as to strengthen the surrounding muscles that can take over the neck brace’s ‘job’ of ensuring proper spinal alignment when the patient starts (around 4 to 6 weeks after surgery) to wean off the neck brace.

Article From : wikipedia.com

Do You Have Lumbar Spinal Stenosis?

Lumbar spinal stenosis (LSS) is a common cause of pain in the lower back and legs. As we get older, our spines go through changes. This is known as spinal degeneration, and it happens to everyone. That being said, even though it happens to everyone, not everyone has negative symptoms that accompany it. When our spines degenerate, the spinal canal may narrow, leading to a condition known as spinal stenosis.

Age-related spinal wear and tear occurs in 95% of people by the age of 50. However, spinal stenosis usually occurs in adults age 60 and older. When the spaces surrounding the spinal canal narrow, it may put pressure on nearby nerves, causing pain. Pressure such as this affects both genders equally.

A minority of patients are born with congenital back problems that later develop into lumbar spinal stenosis. Appropriately, doctors refer to this form of the condition as congenital spinal stenosis. Usually, this form of the condition occurs in men, but it may occur in women as well. For congenital spinal stenosis, symptoms typically manifest between the ages of 30 and 50.

 

Lumbar Spinal Stenosis Causes

Out of all possible causes, degenerative arthritis is the most common culprit of spinal stenosis in patients. For context, arthritis refers to the degeneration of any joint at any point in the body.

In our spines, arthritis results from disc degeneration and the loss of water content. In younger patients, spinal discs have a higher level of water content. However, as patients grow older, the discs begin to dry out, and in turn, they weaken. This may lead to a slew of other problems, such as lumbar radiculopathy or degenerative scoliosis.

As the spine settles, the weight transfers to the facet joints. Additionally, the tunnel that the nerves exit through becomes smaller. As the joints experience increased pressure, the cartilage that protects these joints wears away. If it wears away completely, it results in bone rubbing on bone and causing pain.

When the body loses cartilage in this manner, it may also try to make up for the lost bone by growing new bone in the facet joints. This may sound like a good thing, but it actually leads to the formation of bone spurs. These bony protrusions may put additional pressure on nearby nerves, leading to unpleasant symptoms.

In some cases, the body may respond to arthritis in the lumbar spine by increasing the ligaments around the joints in size. This is known as facet joint hypertrophy, and it also lessens the space surrounding the nerves in the spine. Once the surrounding spaces become small enough, it may irritate the spinal structures.

From : njspine.com

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