Anterior Cervical Discectomy and Fusion

An ACDF is a surgery to relieve pressure on the nerves in the neck and/or to strengthen the neck. Wear and tear of the disc can lead to growth of bone spurs, i.e. osteophytes, that apply pressure on the nerves. Pressure on the nerves may cause pain, weakness, numbness and could even threaten injury to the spinal cord that may lead to paralysis.

During the surgery, a cut is made along one of the creases of the neck. Thereafter, the throat and windpipe are moved aside to reveal the front surface of the spine. Through a microscope, the worn-out disc is removed which takes pressure off the nerves and/or spinal cord. In place of the removed disc, either a polymer cage or a piece of bone from a cadaver is used. To hold the replacement still, a titanium plate the size of a stamp is then affixed and the wound is closed. (See drawing at top of page). There are no stitches on the surface to remove and the glue covering the wound allows the patient to take a shower within several hours. Most patients leave the hospital or surgery center within 4 hours for a single level procedure.

After surgery, nearly every patient experiences a sore throat, difficulty swallowing and a stiff neck. Rarely, a patient may develop prolonged hoarseness to their voice. The surgery reduces the patient’s ability to bend forward and backwards by about 5-10 degrees. An ACDF only minimally effects neck rotation.

Most patients resume activities of daily living immediately and return to sedentary jobs within a week or two. Light exercise such as recumbent bicycling, elliptical exercise and walking on a treadmill can start in about 2 weeks. Heavier activity requires waiting between 8-12 weeks.