ACDF: Spinal Fusion Car Accident Claims

In this post, we will look at the effectiveness of anterior cervical discectomy and fusion (ACDF) as a surgical option for the treatment of chronic back pain. ACDF is a special type of back surgery in which a spinal disc is actually removed in order to relieve nerve root pressure and eliminate chronic pain.

ACDF Surgery

ACDF surgery involves two steps: (1) anterior cervical discectomy; and (2) fusion. The anterior cervical discectomy involves the surgical removal of the targeted spinal disc in the cervical region of the spine. The discectomy is “anterior” because the surgical entry point is done in the front of the neck instead of through the back of the neck, like in most back surgeries.

This frontal approach offers two key benefits. First, it gives the surgeon direct visualization of the cervical discs involved in the back pain and full access to almost the entire cervical spine. It also gives the surgeon a clear, uncomplicated pathway for the removal. Second, the anterior approach tends to result in far less post-operative pain and complications compared to a posterior operation.

The first part of an ACDF procedure involves removing the spinal disc. The second part involves fusion surgery done immediately after the disc removal. The fusion involves placing an implant or bone graft into the space where the spinal disc was removed. The graft or implant will replace the disc and provide strength and stability.

What is ACDF Surgery Used For?

ACDF back surgery is generally used to treat disc herniations in the cervical region of the spine. A herniated disc occurs when one of the spinal discs ruptures, allowing the inner jelly-like tissue to come out, causing painful pinching or pressure on nearby nerves. ACDF can relieve the chronic pain of a cervical herniated disc by removing the disc.

Although most commonly used to treat disc herniations, ACDF is also a treatment option for degenerative cervical disc disease. It is also occasionally used to eliminate symptoms related to cervical spinal stenosis and bone spurs caused by arthritis.

ACDF Surgery Risks and Complications

ACDF is not considered a particularly risky surgical procedure, but like any surgery, it does involve some level of risk and various complications can arise. The primary complications and risks that most frequently occur with ACDF surgery include:

• ACDF surgery does not successfully relieve pain symptoms
• Difficulty swallowing (dysphagia)
• Bone graft or implant fails to heal properly and create a fusion
• Injury to the vocal cord nerves
• Nerve root damage

Aside from these specific risks, ACDF surgery has the same general risks inherent in all surgical procedures.

Is ACDF Effective at Relieving Pain?

Anterior Cervical Discectomy and Fusion is a significant surgical procedure. It is not something you want to leap into. While other spinal surgeries may be performed on an outpatient basis, ACDF typically requires a more involved approach. But substantial evidence supports its effectiveness in alleviating chronic neck and arm pain for some patients.

A comprehensive 2018 prospective study published in Spine followed 159 patients who underwent ACDF for conditions such as disc herniation, stenosis, and degenerative disc disease. Over a minimum follow-up period of 10 years, the study found that patients experienced significant improvements in neck and arm pain, as well as overall function. Notably, 85% to 95% of patients reported successful outcomes, with a substantial decrease in the use of narcotic pain medications. Neurological deficits were largely resolved, and improvements were sustained throughout the long-term follow-up period .

Further supporting these findings, a 2023 study published in BMC Musculoskeletal Disorders examined patients more than 20 years post-ACDF surgery. The study revealed that 88% of participants experienced improvements or full recovery in neck pain and disability. Specifically, 71% reported clinically significant reductions in pain, and 41% noted substantial improvements in neck-related disability.

While ACDF is generally effective, there is no hiding from the fact that there are real risks. Complications such as pseudarthrosis (non-union of the fused segment) and adjacent segment degeneration can occur, sometimes necessitating additional surgical interventions. In the 2018 Spine study, 10% of patients required surgery for pseudarthrosis, and 21% underwent procedures for adjacent segment degeneration over the 10-year follow-up period.

In summary, ACDF has demonstrated high success rates in relieving chronic neck and arm pain, with benefits that can extend over decades.Patients considering this surgery should discuss potential risks and benefits with their healthcare providers to make informed decisions tailored to their individual needs.

What Kind of Car Accidents Cause ACDF Surgery?

Car accidents can result in severe injuries that may require surgical intervention, such as ACDF. ACDF surgery is typically necessary when a patient suffers from significant neck trauma leading to spinal cord or nerve root compression. The surgery involves removing a damaged disc from the cervical spine and fusing the adjacent vertebrae to stabilize the spine and alleviate pain and other neurological symptoms.

Several types of car accidents are particularly prone to causing injuries that might necessitate ACDF surgery. High-speed collisions, especially those involving rear-end impacts, are notorious for causing severe whiplash injuries. Whiplash occurs when the neck is suddenly and forcefully jerked back and forth, which can result in herniated discs or spinal instability. These conditions often lead to severe radicular pain, numbness, and weakness, making ACDF surgery a critical treatment option.

Head-on collisions and T-bone accidents are also common culprits, as the force of impact can directly compress the cervical spine, causing disc herniation or fractures. In such scenarios, the intense pressure on the spinal cord or nerve roots can lead to debilitating pain and loss of function, necessitating surgical intervention to prevent further neurological damage.

How to Link ACDF Surgery and the Car Accident

In some cases, it is obvious that a car accident was the cause of discectomy and fusion.  But there are cases where you need to have the best car accident lawyer you can find to prove the crash is linked to the need for surgery.  Usually, these Challenges in litigation come in the form of an argument that the injuries were pre-existing or not solely caused by the accident. Discrepancies in medical records or delayed treatment can complicate the claims. However, with good lawyering, clear medical evidence, and expert testimony, plaintiffs can significantly strengthen their case and secure substantial compensation to cover their losses.

Expert testimony from medical professionals is especially crucial.  You need a good doctor who can explain the necessity of ACDF surgery and its direct correlation to the car crash.  Detailed accident reports, property damage,  and immediate post-accident medical evaluations further support the plaintiff’s case by demonstrating the severity of the impact and resultant injuries.

Settlement Compensation Amounts for ACDF Surgery in Personal Injury Cases

In terms of compensation, plaintiffs in these cases can seek recovery for medical expenses, including the cost of surgery, hospital stays, and follow-up treatments. Additionally, they may claim lost wages for the time off work due to surgery and recovery periods, as well as non-economic damages for pain and suffering.

Future medical costs related to ongoing care or potential additional surgeries are also considered in the compensation claims.

ACDF Cervical Fusion Settlements and Verdicts

Below are some cases, new and old, that give example settlement amounts and jury payouts in discectomy and fusion car accident lawsuits.

• Dutton v. Foltz Welding (Illinois 2024): A pickup truck collided with a tractor-trailer. The tractor-trailer driver did not seek immediate treatment and finished his route. Ten days later, he sought urgent care for headaches and neck and lower back pain. Six days after that, he returned for further treatment, and the doctors did a full workup on him. An MRI revealed a cervical syrinx at C4/C5, necessitating surgeries, including a syrinx fenestration, C5-C6 fusion, and C4-C5 laminectomy and decompression. At trial, the plaintiff testified. The defendant admitted negligence for the collision but contested the causation of the syrinx and subsequent injuries, arguing the impact was minor and there was a delay in seeking treatment. The jury saw it differently, awarding $12,208,790. This is a good example of a neck surgery C5-C6-C7 settlement or verdict.
• Carbone v. NYC Transit (New York 2024): The plaintiff, a Verizon employee, was stopped at a red light when a sedan behind him was rear-ended by a bus, pushing his vehicle 40 feet into the intersection. The plaintiff sustained neck, back, and shoulder injuries. He was diagnosed with an L5-S1 herniation and annular tear, lumbar and cervical derangements, radiculopathy, facet synovitis, lumbosacral derangement, posterior paraspinal fasciitis, loss of lumbar lordosis, and shoulder injuries, including a partial thickness tear of the right supraspinatus tendon. His treatments included a lumbar epidural steroid injection, arthroscopic shoulder surgery, bilateral facet joint injections, lumbar medial branch blocks, physical therapy, chiropractic treatment, acupuncture, and a decompressive lumbar laminectomy with medial facetectomies, arthrodesis, and bone grafting. Additional bilateral lumbar injections followed. The defense argued that the injuries were not serious and were related to pre-existing conditions. The jury, however, saw it very differently. It found that the injuries significantly limited his ability to perform daily activities and awarded him $23,360,765. This case is a good example of why ACDF surgery settlements can have very high payout values.
• Missey v. Defendant (Missouri 2024) $3,000,000 Settlement:  A tractor-trailer rear-ended the plaintiff on Interstate 70 in St. Louis. The plaintiff underwent chiropractic treatment, physical therapy, and, eventually, a cervical spine stimulator implantation. Complications from the procedure, including bleeding, led to the removal of the stimulator and a subsequent spinal fusion, resulting in permanent pain and limitations.  The defense argued that the traffic stop was sudden, the impact was minor, and the treating provider was responsible for ongoing issues. The case was settled after expert depositions.
• Dojec v. 1302 Realty Company (New York 2024) $19,774,079 Verdict:  This is not a car accident case, but it is still an instructive verdict.  A construction worker in his 30s sustained severe injuries while doing demolition work at a school. He was using a handheld grinding tool with a wood saw blade when the blade kicked back and cut his right leg, causing him to fall and further injure his neck and back. The worker sued the property owner and his employer, alleging violations of industrial code and labor laws, particularly citing missing safety guards on the tool.  He suffered a severe right thigh laceration, a partial tear of the vastus lateralis muscle, mononeuritis, cervical and lumbar herniations, lumbar facet arthropathy, and radiculopathy. He underwent physical therapy, received lumbar epidural steroid injections, and had three spinal surgeries, including an L5-S1 microdiscectomy, a C5-6 anterior cervical decompression and fusion, and an L5-S1 anterior and posterior fusion. He developed psychosis and depression post-incident and continues to require physical therapy and counseling, and uses a cane. He can no longer work as a laborer and needs ongoing medical treatments.  The jury found that the employer had violated industrial safety codes, which were a substantial factor in causing the accident. Despite finding the worker negligent, his negligence was not deemed a substantial factor in the incident. The jury awarded $19,774,079 for future medical expenses, lost earnings, and pain and suffering.
• Feather v. Heddings (Virginia 2023):  A driver fell asleep and drifted into the plaintiff’s lane, causing a car crash. The plaintiff suffered cervical and lumbar spine injuries, requiring an anterior cervical discectomy and fusion at C4-5, as well as a lumbar fusion from L3-5. Due to ongoing symptoms, the plaintiff’s neurosurgeon later opted for a spinal cord stimulator and implantable pulse generator. Despite the defendant having only $25,000 in liability coverage, the plaintiff’s significant underinsured motorist policy provided additional compensation. The underinsured motorist carrier promptly offered the full $975,000 in coverage available. The case was resolved with a $1,000,000 settlement.  That was all of the insurance coverage; the case was worth a lot more than $1 million. This case would fall into the category of a 2-level cervical fusion settlement.
• Cifuentes v. Rodriguez (Virginia 2022): The plaintiff was rear-ended. He was initially treated three days post-accident, where an MRI revealed degenerative changes in his cervical spine. He completed four months of physical therapy and acupuncture. Following an 18-month gap in treatment, the plaintiff underwent a right C4-7 anterior cervical discectomy and fusion in October 2019. Again, expert testimony is key.  His expert testified that the trauma from the accident aggravated the pre-existing degenerative changes and that the surgery was related to the collision. The defendant had an expert, too, of course, who claimed the plaintiff only suffered a neck strain and that his symptoms resolved after physical therapy. The jury awarded $400,000.
• Swain v. Bi-State Development Agency (Missouri 2021).  A 34-year-old mother was injured when the Metro bus she was riding to work was struck from behind by another Metro bus. Thrown to the ground, she suffered neck and shoulder pain, leading to C4-5 and C5-6 herniations with resultant radiculopathy. After two years of therapy, specialist consultations, and pain treatment, she underwent a two-level cervical discectomy and fusion. To give you an idea of how these things go, the defendant initially offered $12,500. The final settlement was  $435,849.
• Plaintiff v Defendant (Idaho 2020) $550,000 Settlement: The defendant failed to yield the right-of-way at an uncontrolled intersection, resulting in a collision with the plaintiff. The plaintiff suffered a neck injury at C6-7 requiring surgery for an anterior cervical discectomy and fusion (ACDF) with allograft. Right shoulder injury requiring surgery for rotator cuff repair, subacromial decompression, distal clavicle excision, and biceps tenodesis.
• Vitus v. Southern Oregon Edu. (Oregon 2019) $400,121 Verdict: Plaintiff suffered back injuries and whiplash and had continuing pain. Plaintiff’s orthopedic expert identified annular tears on the MRI and recommended that Plaintiff undergo surgery for an anterior cervical discectomy and fusion (ACDF), but stated that it is up to Plaintiff whether she does the surgery or not. In his perpetuation deposition, he gave a 55% likelihood that Plff needs this surgery.
• Holland v. State Farm (Idaho 2018) $112,500 Verdict: Plaintiff was hit in a low-speed collision. Prior to the accident, she had undergone 2 prior ACDF surgeries for pre-existing injuries. She sued the at-fault driver, alleging that the collision required her to undergo a third ACDF surgery. Jury awarded $112,500.
• Sala v White (New Jersey 2014) $550,000 Settlement: Defendant ran a stop sign and struck the plaintiff’s vehicle, causing aggravation of the plaintiff’s pre-existing back injury. Plaintiff underwent ACDF surgery to treat multiple cervical disc herniations and surgery to repair a torn rotator cuff injury from an accident.
• Larsen v Slutter (Indiana 2014) $205,000 Verdict: 68-year-old plaintiff suffered cervical spine and shoulder injuries in an auto accident requiring ACDF surgery and 9 days in the hospital.
• Koon v Auto Owners Ins (Michigan 2010) $115,000 Settlement: Plaintiff alleged that he suffered progressive injuries to his cervical spine in an auto collision and that ACDF surgery was necessary treatment. The insurance company disputed whether surgery was necessary, but eventually agreed
  to settle.

Contact Miller & Zois About Your Back Injury Case

If you injured your back in an auto accident or other incident caused by the negligence of another, contact the personal injury lawyers at Miller & Zois for a free case evaluation.