Anterior cervical discectomy and fusion (ACDF)

Apa ACDF tu??

Saya sekadar google from internet aje slepas dpt sms dari adik saya. This is one kind of major surgery operation that she will going through soon on 23rd August  at Hospital  Perempuan Raja Zainab II Kota Bharu.

A bit info i got from wikipedia. (Tapi byk istilah2 perubatan yg sy tak fahami..maklum la bljr istilah part bdn2 manusia cuma masa zaman sekolah aje. Matrikulasi saya tak amik sains hayat.)

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 in order to stabilize the corresponding vertebrae. This procedure is used when other non-surgical treatments have failed.

Anterior cervical discectomy

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. This nerve root becomes inflamed and causes serious pain. The problem can also be caused by 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.
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 bone graft, taken from the pelvis or cadaveric bone. 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.
The surgery requires a short stay in the clinic (1 to 3 days) and a gradual recovery between 4 to 6 weeks.

                 

Vertebra and disc : normal and herniated situation (top view)

Buat masa sekarang adik saya tengah bercuti dikampung a.k.a MC selama 21 hari diberikan oleh doktor bermula dari tarikh prosedur MRI dia 3/8/11 baru2 ni. Selepas didiagnos dan mcm2 prosedur dibuat..doktor cakap satu pembedahan akan dilakukan insya Allah pada 23/8 nnt. Saya tau dia sangat2 berdebar sekarang, saya hanya mampu doakan dia dari jauh ni aje..nak balik Terengganu sblum prosedur pembedahan dia tu mcm tak tercapai aje hajatnye..maklum la suami saya keje 6 hari seminggu, chances utk blk kg sgt la limited.

Kenapa dia akan menjalani pembedahan major itu?? Actually, sakitnya dah lama dah..dari zaman dia belajar kat uni lagi. Kind of mysterious jugak mulanye sbb tak tau sakitnye ape. Dia penah kena Bell Palsy (if i'm not mistaken) seketika zaman dia belajar dulu. Ape benda lak Bell Palsy ni kan?

Bell's palsy is an acquired weakness of one side of the face, due to an injury to the facial nerve. The symptoms on the affected side typically include inability to close the eye, to smile, wrinkle the forehead and whistle. Speech may be mildly slurred. Tearing occurs because the eye does not close completely. Taste sensation may be diminished on the front half of the tongue. Sounds may appear louder on the affected side (hyperacusis) -- this may be caused by paralysis of the stapedius muscle but also occurs independantly. Papillitis may be seen of the fungiform papillae of the affected side. Bell's palsy usually develops over hours to days. The peak involvement usually happens within several days. Mild pain behind the ear is common at onset, as is a subjective sensation of "numbness" of the affected side. Usually it is first noticed when a persons observes it in a mirror, or on eating because food tends to collect between the cheek and gums.

Selain tu katanya tangan dan kakinya juga kdg2 rasa kebas dan lenguh2. Dia suspek maybe sakit2 tu bermula since after dia join aktiviti Silat di Universiti dulu. Maybe ade la mana2 aktiviti seni bela diri tu yang masa buat aksi2 berlawan/defends tu menyebabkan pukulan yang agak kuat sket la hingga ade effect kat tengkuk/leher dia yang bakal disurgery tu. Tapi katanya klu pukulan yang btul2 kuat maybe dh buat dia pengsan terus masa aktiviti silat dulu.. Dulu setakat amik ubat2 aje.. but lately adik saya cakap  kdg2 sakit tu makin menjadi2 pulak. That's why buat prosedur MRI tu nak kenal pasti kat mana masalahnye. Dia penah balik ke Terengganu utk buat check-up (She's working in Mukah, sarawak) masa bulan 7 tu tapi tak dapat detect lagi ape masalahnye then buat appointment utk MRI di Kota Bharu. Lucky that my cousin's wife who is a doctor bahagian radiology ni jugak..so dapatla cepatkan prosedur tu.

So sekarang hanya mengunggu hari untuk menjalani pembedahan itu aje. Semoga semuanya selamat dan she'll be fine after that...nampaknya raya kali ni dia pun tak dapat beraya sakan sangat la.. maklum la baru aje lebih kurang seminggu after surgery tu. Dia cakap hatinya sekarang penuh dengan debaran maklum la nak hadapi major surgery...yang memakan masa maybe about 3-4 hours. Ape komplikasi selepasnya dan macam2 lagi la kan perlu utk dia bertenang mulai sekarang. Klu nak ikutkan saya pun rasa nervous jugak ni mendengar ceritanya. Moga2 dia akan cepat sembuh selepas pembedahan tu nnt..maklumla berjawatan sebagai guru di salah sebuah sekolah di Mukah Sarawak nun...Mengajar pulak subjek Math & Add Math. of course la dia juga risau dengan pelajar2nye yang bakal menduduki peperiksaan nnt.


Dear Nadiah,
Kak Ida dan abang Pyan kat sini mendoakan yang terbaik utk kamu. Semoga kamu selamat menjalani pembedahan itu nanti. Moga2 berkat Ramadhan ini akan menyelesaikan masalah yang kamu hadapi itu nnt. Selamat berpuasa bersama mak ayah di rumah yer!