Orthopaedic Protocols. Post-Surgical Rehabilitation Protocol: Cervical Laminectomy, Discetomy, Fusion. I. Post Op Days A. Precautions. Post operative Spine Rehab-Cervical Fusion. Treatment Avoid flexion with posterior cervical fusion Upper extremity extension isometric exercises. 3. Anterior cervical discectomy and fusion (ACDF) is one of the most common MD , rehabilitation department, Cervical Fusion Protocol (level of evidence: 5) [17].

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Anterior cervical discectomy and fusion

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If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. Original Editors – Stacy Callow. Anterior cervical discectomy and fusion ACDF is one of the most common surgical procedures performed by neurological and spinal orthopedic surgeons. Most common cause for this operation is a ruptured cervical intervertebral disk. Another reason for surgery are spurs that irritate a nerve root With the operation, specialists can remove these spurs.

Rehaab two upper vertebrae have a unique shape. The five remaining vertebrae have a bearing function. The main functions of the cervical spine are to support the head and allow the motility of the head and the most important muscles in this region are 1 M. Treatment effectiveness following spine surgery is usually measured with the help of patient-reported outcome PRO questionnaires.

Here reflect minimum clinically important differences MCID clinically meaningful improvements to patients6. The incision is made in the front of the spine through the throat area.

After the disc is removed, a bone graft is inserted to fuse together the bones above and below the disc space. Discectomy literally means “cutting out the disc.


The surgeon reaches the damaged disc from the front anterior of the spine through the throat area.

By moving aside the neck muscles, trachea, and esophagus, the disc and bony vertebrae are exposed. Surgery from the front of the neck is more accessible than from the back posterior because the disc can be reached without disturbing fehab spinal cord, spinal nerves, and the strong neck muscles.

Accf on your particular symptoms, one disc single-level or more multi-level may be removed. After the disc is removed, the space between the bony vertebrae is empty. To prevent the vertebrae from collapsing and rubbing together, a spacer bone graft is inserted to fill the open disc space. The graft serves as a bridge between the two vertebrae to create a spinal fusion. The bone graft and vertebrae are fixed in place with metal plates and screws.

Following surgery the body begins its natural healing prktocol and new bone cells grow around the graft. After 3 to 6 months, the bone graft should join the two vertebrae and form one solid piece of bone.

The instrumentation and fusion work together, similar to reinforced concrete. With regard to the postoperative pysphagia, a LEO approach lateral surgical dissection to the omohyoid muscle should be selected if the level of surgery involves C3-C4. After fusion, you may notice some range of motion loss, but this varies according to neck mobility before surgery and the number of levels fused.

If only one level is fused, you may have similar or even better range of motion than before surgery. If more than two levels are fused, you may notice limits in turning your head and looking up and down Therefore protocols are used.

Deviations from the protocol are dependent on prior level of function, general health of the patient, equipment available, patient goals, specific orders written on the prescription, and others. Three important components of the therapy are scapular stability, cervical stability, and functional activity. It is important that the patient follow the limitations set forth from the physician during the first two weeks and then a gradual progression toward functional activities that do not place excessive stress to the cervical region.


Most studies conclude an improvement in neck pain, arm pain and range of motion. If we compare to other treatments such as cervical arthroplasty, we can say that patients who received Mobi-C TDR device for treatment of 2-level symptomatic degenerative disc disease experienced significantly greater improvement than ACDF patients in NDI score at every time point and significantly greater improvement in VAS neck pain score at 6 weeks, and at 3,6n and 12 months postoperatively.

The reoperation rate was significantly higher in the ACDF group at When we look to a surgical treatment for single-level cervical symptomatic degenerative disc disease, we can conclude that after 5 years, ProDisc-C patients had statistically significantly less neck pain intensity and frequency A comparison between a cervical disc arthroplasty with anterior cervical discectomy and fusion for the treatment of cervical spondylotic myelopathy works to the advantage the arthroplasty where there was a lower incidence of complications It is better to choose a Zero-Profile implant in an anterior cervical discectomy and fusion.

In the early follow-up the incidence of dysphagia was lower compared with that in the cage with plate and the symptom duration was much shorter Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; a double-blind randomized multicenter study.

Anterior Cervical Discectomy and Fusion.

Anterior cervical discectomy and fusion associated complications. Walker; Reviewed by Jason M.

Anterior cervical discectomy and fusion – Physiopedia

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