If you are suffering from back pain for quite a long time and your doctor has recommended you the neck fusion surgery then you have come to the right place.
We will discuss all this procedure as well as its alternatives in this article. First of all the biological term for this procedure is ACDF. What does it stand for? Well, it means, Anterior Cervical Discectomy and Fusion Surgery.
This procedure involves the removal of diseased discs and fusion of bones together. It is the treatment option available for patients that suffer from chronic pain in the neck region.
This surgery isn’t indicated for all kinds of back pains. There are certain specific conditions, for which its indicated. Those include:
If there are visible signs of disc damage on an imaging scan. Patients feel the numbness of hand and arms due to pressure on nerves caused by disc damage.
If there is chronic and severe pain in the neck region. Noneffective previous treatment options. Advantages: This procedure restores normal activity to some extent. It also relieves chronic pain in the neck region.
Why do We Need Alternatives?
It is not a 100% safe procedure and there is certain risk associated with it. Those include:
Risks associated with general anesthesia. Risk of infection at the site of the incision. More than normal blood loss Chances of CSF leakage. Brain infection.
There are multiple other options available instead of surgery.
These are advised for the patients that have the diseased disc but do not suffer from chronic pain.
These neck fusion alternatives are as follows:
1-Physical activities like engaging the patient in some kind of exercises prescribed by the physician.
3-Intravenous drug therapy
Other Surgical Alternatives:
Other surgical alternatives to neck fusion surgery are as following:
1-Intradiscal electrothermal coagulation
4-Posterior dynamic stabilization
INTRADISCAL ELECTROTHERMAL COAGULATION:
This procedure is also known as annuloplasty. In this procedure, heat is transferred to the outer part of the disc which is called annulus, using a catheter. This procedure is carried out under local anesthesia.
After administration of local anesthesia, a hollow needle containing a catheter is inserted. The catheter is placed in a circle in the outer layer (annulus) of the disc and then it is heated to a temperature of 90-degree celsius slowly.
The main purpose of heating the disc is to destroy the nerve that has grown to the outer layer of the disc and also to toughen the disc outer layer and to seal any of the small tears.
To prevent the disc damage antibiotics are given either intravenously or directly administered to the disc. The pain relief following the IDET is not immediate. Physiotherapy is necessary during recovery phase.
This is a less invasive procedure than that of neck fusion surgery.
There is no risk associated with general anesthesia as this procedure is carried out under local anesthesia.
There is no risk of infection of incision that is associated with neck fusion surgery.
This is an outpatient procedure and the hospital stay of the patient is not required.
This procedure helps in relieving the pain caused by disc damage.
Pain relief is not immediate.
This procedure is not indicated in patients with severe disc damage.
Complications associated with this procedure are rare, some of the risks are
This procedure involves removal of the diseased or degenerated disc and its replacement with an artificial disc.
This is an invasive procedure.
This procedure helps in reducing the pain of disc damage as the diseased disc is being replaced with the artificial disc.
As compared to the neck fusion surgery this procedure helps in maintaining the normal range of motion at the site of disc replacement.
This is indicated for the patients with severe disc damage and only to those patients who can afford it.
It relieves pain.
It enables the patient to perform movements in a normal range.
Unlike the neck fusion surgery, it prevents the wearing of adjacent segments by preserving the normal range of motion at the site of disc replacement.
This is an invasive procedure.
All the risks associated with neck fusion surgery are also present in this procedure such as risk associated with general anesthesia, infection, etc.
The artificial disc wears out with the passage of time and revision surgeries are often needed. This procedure is very expensive and not affordable for most of the patients with severe disc damage.
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This procedure helps in relieving the pressure on the spinal cord, caused by degenerated or herniated disc, by increasing the size of the vertebral canal in the cervical region.
This is an invasive procedure. It is carried out under general anesthesia. In this procedure instead of removing the diseased disc or bone spurs the bone adjacent to the spinal cord which is called lamina is reconstructed.
The lamina adjacent to the spinal cord compression area is partially cut on both right and left the side and on one side a hinge is created and on another side, an opening is created which helps in relieving the pressure. this is called “one door” technique.
There is another technique called the “french door” technique in which a hinge is created on both the right and left side of lamina and opening is created in the center.
Then the bone graft is stabilized at the site of the opening using mini plates. This procedure is indicated in patients having multiple level spinal cord compression.
This procedure helps in relieving the symptoms caused by spinal cord compressions like numbness, tingling, and weakness of hands and arms. These symptoms are relieved but it takes the time of several months.
Multilevel spinal cord compression can be treated with this procedure without removing the damaged disc or bone.
This procedure alleviates pressure on the spinal cord thus reduces the pain and creates a healing environment.
Like neck fusion surgery this procedure is also linked with surgical risks.
The recovery period for this procedure is for several months.
POSTERIOR DYNAMIC STABILIZATION:
This procedure helps in relieving the pressure on the degenerated disc by stabilizing the adjacent vertebrae in the posterior aspect using moveable devices. Thus it relieves the pain caused by diseased disc and also provides a favorable environment for healing.
The devices used for stabilization and their advantages and disadvantages are not well understood and research is under process on these topics.
The research is being performed to identify the genes that are necessary for disc regeneration.
It is thought that bone morphogenic protein-12 gene (BMP-12) increases the cell formation in both annulus and nucleus of the disc might play a role in disc degeneration as it also helps in embryonic joint formation.
Research is also ongoing to find out the gene responsible for inhibition of disc degeneration. This gene therapy may also help to reduce the pain in the neck region.