Anterior Cervical Disc Replacement (ACDR)

Anterior cervical discectomy replacement is a newer procedure that preserves motion after removing degenerated discs and relieving compression on the spinal cord and nerves in select patients.

This procedure is similar to an ACDF, but instead of using bone and plates, it uses a unique construct allowing motion between the vertebra.

With this approach, one or two discs can be removed, decompressed, and replaced with this technology.

Not all patients are candidates for disc replacements, but EvergreenHealth surgeons will consider every single patient's candidacy for this procedure.

ACDR is typically used to treat:  cervical disc herniation, cervical foraminal stenosis, radiculopathy, myelopathy, cord compression.

Anterior Cervical Discectomy Replacement Surgery

During an ACDR, you will lie on your back and the surgeon will make a small incision on the left or right side of your neck, just off the midline.

The surgeon will then retract your esophagus, trachea, blood vessels, ligaments and muscles off to either side. This approach to surgery provides a straightforward pathway to your spine and minimal soft tissue damage.

Using X-ray fluoroscopy and a microscope, your surgeon will identify the disc or level causing your symptoms.

The surgeon carefully removes the disc, bone spurs, herniated fragments, cartilage, and calcified disc fragments. This allows us to directly decompress your spinal cord and nerve roots.

Once completed, a special-sized artificial disc fitting your exact anatomy is placed into the empty space.

This device helps restore normal disc height, provides indirect decompression for your nerve roots, but still allows for motion between the two vertebrae, allowing you to maintain normal motion that is otherwise sacrificed during a fusion.

How Anterior Cervical Disc Replacement (ACDR) Surgery Works

The ACDR is relatively newer technology but is showing promising results throughout the world.

It provides similar excellent outcomes in terms of patient satisfaction, and, like an ACDF, allows surgeons to directly remove the source of compression.

By removing degenerated, herniated, or calcified discs and bone spurs, we can directly visualize the spinal cord and make sure it is free while simultaneously decompressing directly over the nerve roots.

The placement of the artificial disc rebuilds neck height and reestablishes the normal “curve” that is sometimes lost with arthritis and degeneration.

Lastly, the artificial disc has cutting-edge technology that allows for normal neck motion, so patients' flexibility is not compromised.

The disruption allows for minimal muscle damage; usually we can get to your spine between the various tissue planes of the neck including the muscles and ligaments of the anterior neck. This usually results in less pain after surgery and faster recoveries.

Benefits of ACDR

Because the ACDR is not a fusion, it possesses all the traditional of benefits of the ACDF in addition to maintaining range of motion and flexibility in the neck.

There is some evidence that it may also prevent adjacent segment degeneration, perhaps lessening the need for additional surgery down the road.

After Anterior Cervical Disc Replacement (ACDR) Surgery

The vast majority of patients who have the ACDR procedure leave the hospital within 24 hours after surgery.

Patients are typically kept overnight as a precautionary measure to monitor the ability to breathe, speak and swallow.

The ACDR procedure can be performed safely in an outpatient environment under careful and controlled circumstances.

Recovery and prognosis after ACDR are excellent.

Recovery from the initial surgical procedure can take a few days to a week.

Muscle spasms between the shoulder blades are also common in the weeks after surgery.

Typically, most patients are able to return to basic functioning (cooking, cleaning, walking up and down stairs, etc.) within a few days.

Dysphagia, or difficulty swallowing, can take a few weeks to improve, but most patients have no problem adjusting their diet for a week to softer foods in the meantime.

The majority of patients can return to normal activity within six months without restriction.

Oftentimes, your surgeon will put you on a non-steroidal anti-inflammatory medication (NSAID), such as indomethacin or ibuprofen for 4 weeks after surgery to prevent fusion.

You may be given a soft collar to use for the first week for comfort only.

We ask that you walk plentifully, limit lifting to no more than 15lbs for the first month, and avoid prolonged periods of bed rest outside of sleeping at night.