Anterior Cervical Disc Replacement (ACDR)

What is Anterior Cervical Disc Replacement (ACDR)?

Anterior Cervical Disc Replacement (ACDR) is a surgical procedure used to treat conditions of the cervical spine (neck) that affect the intervertebral discs. These conditions may include:

  • Herniated discs

  • Degenerative disc disease

  • Spinal stenosis

During ACDR, a damaged or degenerated disc in the cervical spine is removed and replaced with an artificial disc to restore motion and stability to the neck. This procedure is an alternative to traditional spinal fusion surgery and aims to preserve the natural movement of the spine.

Indications for ACDR:

ACDR may be recommended if you have:

  • Persistent neck and arm pain, numbness, or weakness that doesn’t improve with conservative treatments (such as physical therapy, medications, or injections)

  • A herniated or degenerated disc causing compression of spinal nerves

  • Reduced spinal mobility or quality of life due to cervical disc problems

Procedure Overview:

  1. Incision: A small incision is made at the front (anterior) of the neck to access the cervical spine.

  2. Disc Removal: The damaged disc causing nerve compression is carefully removed.

  3. Artificial Disc Insertion: An artificial disc, made from materials like metal or plastic, is placed in the space where the damaged disc was located. The artificial disc is designed to mimic the function of a healthy, natural disc and preserve neck movement.

  4. Stabilization: Unlike fusion, which requires the vertebrae to be fused together, ACDR maintains the natural motion of the spine.

Pre-Surgery Instructions:

  • Medications: Inform your surgeon of any medications you are taking, especially blood thinners, as you may need to stop taking them before surgery.

  • Fasting: You should not eat or drink anything after midnight before the surgery.

  • Pre-Op Testing: Your doctor may order tests such as blood work, X-rays, or MRIs to assess your condition before surgery.

Post-Surgery Care:

  • Hospital Stay: Most patients can go home several hours after surgery, however some patients stay overnight following surgery.

  • Pain Management: You will likely experience some discomfort or pain after surgery. Your doctor will prescribe pain medications to help manage this.

  • Neck Brace: You may need to wear a neck brace for a short period to stabilize the area while healing.

  • Activity Restrictions: Avoid heavy lifting, bending, or twisting your neck for the first few weeks after surgery. Your doctor will provide specific guidelines for activity restrictions and when you can return to normal activities.

  • Physical Therapy: Physical therapy may be recommended to help you regain strength and flexibility in your neck.

Possible Risks and Complications:

While ACDR is generally safe, like any surgery, there are risks involved. These include:

  • Infection at the incision site

  • Bleeding or blood clots

  • Nerve injury

  • Difficulty swallowing or hoarseness

  • Allergic reaction to the artificial disc material

  • Implant failure or malfunction

  • Continued neck or arm pain

It’s important to discuss these potential risks with your surgeon to fully understand the procedure.

Follow-Up Appointments:

You will need to attend follow-up appointments to monitor your healing and assess the function of the artificial disc. During these visits, X-rays or other imaging may be taken to evaluate the position of the artificial disc and ensure the spine is healing properly.

When to Contact Your Doctor:

Call your surgeon if you experience any of the following symptoms:

  • Severe pain, swelling, or redness around the incision

  • Signs of infection (fever, chills, drainage)

  • Numbness, tingling, or weakness in your arms or legs

  • Difficulty swallowing or breathing

  • Unusual or persistent pain

Recovery and Prognosis:

  • Healing Time: The initial healing phase may take several weeks, but it can take up to 6-12 months for full recovery and for the artificial disc to fully settle into place.

  • Long-Term Outcomes: ACDR typically results in significant improvement in pain relief and range of motion. Since the artificial disc preserves motion, it can help maintain a more natural function of the cervical spine compared to fusion.

Important Notes:

  • Always follow your surgeon's post-operative instructions to avoid complications and promote healing.

  • Family or friends may be helpful in assisting with your recovery in the first few weeks following surgery.

  • If you have any questions or concerns about the surgery, recovery, or any aspect of your care, feel free to reach out to your healthcare provider.