Anterior cervical discectomy and fusion (ACDF) is a procedure to treat certain injuries and conditions affecting the vertebrae and nerves in your cervical spine (the upper backbone that supports your neck). This section of the spine consists of seven interlocking bones called vertebrae that are separated by discs, which help provide stability and cushioning for the neck’s frequent movements.

Problems in the cervical spine, such as vertebral fractures or herniated discs, can cause painful pressure on nearby nerves or increase the risk of spinal cord injury. When this happens, the ACDF procedure may be recommended to remove one or more discs in the affected area and fuse together adjacent vertebrae.

Baptist Health is nationally recognized for excellence in spine care. We offer a full spectrum of orthopedic and neurologic care and the latest approaches to ACDF. Best of all, you’ll appreciate convenient appointment times, locations near you and a personalized focus to meet your needs before, during and after your procedure.

What is Cervical Discectomy and Fusion?

ACDF is a procedure in which your surgeon removes the affected cervical disc and replaces it with bone graft material to gradually fuse the nearby vertebrae and prevent them from moving apart. This can strengthen this section of the neck to help compensate for the removed disc. Your surgeon may use one of three types of bone graft:

Autograft

ACDF procedures commonly use an autograft, a bone graft taken from the patient’s own body. This material is less likely to be rejected by the patient’s immune system.

Allograft

This type of graft comes from a bone bank rather than the patient’s own body. This alternative lets the patient avoid the postoperative pain associated with the removal of bone material, but it may provide less optimal healing compared to an autograft.  

Synthetic Graft

In some cases, a synthetic material may be used to support bone growth and help the vertebrae heal faster.

Additional Components

To help the vertebrae fuse successfully, your surgeon may attach a metal plate with screws to keep the vertebrae from moving apart.  

What Can Cervical Discectomy and Fusion Accomplish?

ACDF is performed to treat certain neck problems related to the cervical vertebrae and discs in between. Those problems can include herniated discs, degenerative disc disease, broken vertebra, stenosis or spondylolisthesis. This procedure is only recommended for symptoms related to a herniated or deteriorated disc when the symptoms do not respond to at least six weeks of nonsurgical treatment. This procedure is recommended to:

• Relieve severe pain, numbness or weakness in the neck, shoulder, arm and hand
• Treat compression of the spinal cord
• Stabilize the bone sin the neck

What Can I Expect During the Procedure?

This procedure typically takes one to two hours and is performed while you lie on your back under general anesthesia. While you sleep, your surgery team may use a ventilator to ensure proper air flow to the lungs.

Your surgery team will begin by preparing a bone graft for the fusion. If the graft comes from your own body, it is typically removed from the pelvis through a small incision, which is then stitched up. ACDF happens in two parts:

Discectomy

The surgery is performed on the front (anterior) of the neck. The surgeon makes a two-inch incision just above the collarbone and to the side of the windpipe. Skin, muscle and other soft tissue are gently held aside to allow access to the affected area, and an X-ray is used to identify the location of the disc that is to be removed. Using forceps, the surgeon carefully extracts the damaged disc from between the vertebrae and removes any nearby bone spurs that may be contributing to nerve compression.

Fusion

Before inserting the bone graft between the vertebrae, your surgeon will prepare the graft site by shaving off a layer from the surfaces of the vertebrae that will press against the graft. Then, your surgeon inserts the bone graft in the empty disc space. A metal plate may be installed to hold the vertebrae in place while the graft fuses them together. Finally, the skin above the surgery site is stitched together and you are moved to a recovery room.

Your surgeon may be able to perform ACDF as a minimally invasive procedure in an outpatient setting. This procedure uses multiple smaller incisions instead of one larger one. A minimally invasive ACDF is performed with specialized tools including an endoscope, which is a narrow tube with a light and camera to help the surgeon view and operate on the spine. This option can lessen the procedure’s impact on the body, helping reduce postoperative pain and recovery time.

Recovery

Patients typically go home the same day or after one night of recovery in the hospital. While not necessary, a special neck brace may provide added comfort during the first few days of recovery.

Estimated Recovery Timeline

Your doctor may prescribe up to three months of physical therapy to help you manage pain and inflammation and to aid in the recovery process. This typically begins about a month after the surgery. Your doctor will also talk to you about how long to wait before returning to work. Recovery can take two months or longer, and it may take up to 18 months for your vertebrae and bone graft to completely fuse together. Your doctor may prescribe a neck brace for you to use for several weeks after surgery.

Cervical Discectomy and Fusion Risks

Any surgery carries risks, but ACDF is typically a safe and effective procedure to treat certain neck problems related to damaged discs and vertebrae. The risks associated with ACDF may include:

• Bone graft failure
• Infection
• Poor wound healing
• Bleeding
• Blood vessel or nerve injury near the surgery site
• Dural tear or spinal fluid leak
• Potential speech disturbance due to nerve damage

After your procedure, your doctor will provide instructions to help you care for the surgery wound and will tell you which activities to avoid soon after your surgery to promote a faster recovery.