Anterior Cervical Discectomy and Fusion (ACDF) Surgery

What is ACDF Surgery and Why is it Done?  

ACDF is a surgical procedure to remove a damaged (degenerated) or herniated disc in the neck (cervical spine) that is causing neck pain or pressing on nerves or the spinal cord, causing pain, numbness, or weakness in your neck, arms, shoulders, or legs. After removing the disc, the surgeon fuses the nearby vertebrae (bones in your spine) to keep your neck stable. The goal is to relieve pain and other symptoms caused by the damaged disc or pinched nerves or spinal cord.

How is the Surgery Performed?  

- Anesthesia: You’ll be under general anesthesia, so you’ll be asleep and feel no pain during the procedure.  

- Incision: The surgeon makes a small (about 1-inch) cut in the frontolateral aspect of your neck, typically on the right side, gently moving muscles aside to reach the spine.  

- Disc Removal: The damaged disc is removed, which creates an environment for fusion or relieves pressure on the nerves or spinal cord, reducing your symptoms.  

- Fusion: A small implant (comes in different sizes and from different materials - PEEK, titanium, etc.) is placed in the empty disc space to help the vertebrae grow together, forming a solid bridge. Sometimes, small screws or a plate are added to hold the bones in place while they heal.  

- Closing: The incision is closed, leaving a small scar that often fades over time.  

The one-level surgery usually takes from 40 minutes to 1 hour, and most patients are discharged from the hospital the next day after the surgery.

Benefits of ACDF Surgery  

- Less Pain: The surgery avoids cutting through major muscles, so there’s typically minimal discomfort after the procedure. Short-term discomfort can include difficulty in swallowing solid foods, hoarseness, and minor pain at the surgery site. 

- Faster Recovery: Most patients return to fully normal activities within weeks, though office work can be restarted in a few days after the surgery. 

- Effective: ACDF is a trusted and widely used procedure for treating neck disc problems.  

- Affordable: It’s generally less expensive than other options, like artificial disc replacement.  

Possible Risks and Complications 

While ACDF is generally safe, all surgeries carry some risks. These are rare but may include:  

- Adjacent level disease: The fused area may put extra stress on the nearby intervertebral disc, which could lead to wear and tear over time (3-10 years), sometimes requiring additional surgery to fix it

- Temporary Issues: Some patients experience short-term difficulty swallowing or hoarseness.  

- Fusion Problems: In rare cases, the bones may not fuse properly, requiring further treatment.  

- General Surgery Risks: These include bleeding, infection, blood clots, or reactions to anesthesia.  

Your surgeon will explain these risks in detail and help you weigh the benefits and risks based on your condition. Following your surgeon’s instructions before and after surgery can help reduce these risks.

Talk to Your Surgeon 

ACDF is a proven way to relieve neck pain and nerve/spinal cord compression-related symptoms for many patients. If you’re considering this surgery, discuss your symptoms, concerns, and questions with your doctor to ensure it’s the right choice for you.