Anterior Cervical Discectomy and Fusion (ACDF)

Dr. Jonathan Hall

Dr. Jonathan Hall

Dr. Hall is a Board Certified Neurosurgeon that specializes in treating patients that suffer from neck pain or back pain. He is able to perform minimally invasive spine surgery and the most complex procedures.

Damaged DiscIf your surgeon recommends surgery to treat neck pain or spinal disorders, such as cervical disc herniation, there are many things you’ll need to consider. Your first question may be how long you will need to stay in the hospital, as well as what to expect in terms of the recovery process. These are legitimate concerns. Knowing that minimally invasive spine techniques can be used to treat pain or neck disorders in an outpatient setting may help alleviate some of your concerns. Among these procedures is anterior cervical discectomy and fusion, or ACDF.

Compared to traditional open neck decompression and stabilization surgery, minimally invasive ACDF has many potential advantages, including a smaller incision site and a quicker recovery period. There is, however, a limit to the number of people who can undergo this procedure in an outpatient setting.

Your particular diagnosis will be considered when determining whether you are a good candidate for ACDF. A minimally invasive ACDF procedure may also be appropriate for patients with other serious health problems, such as a heart condition. Patients with such conditions should undergo their surgery in a hospital in case unexpected treatment is necessary for their condition.

If you are considering ACDF surgery continue reading to learn about the following:

  • What Is ACDF Surgery?
  • What Is ACDF Used To Treat?
  • What to Expect After ACDF Surgery
  • Surgery Prevention
  • Alternatives to Surgery

What Is ACDF Surgery?

An anterior cervical discectomy and fusion (ACDF) is a procedure to remove herniated or degenerative cervical discs. Once the surgeon has removed the damaged disc, the bones are fused together. In anterior surgery, the disc is accessed from the front of the neck rather than from the back.

A cushion called an intervertebral disc lies between each bone of the spinal column. These discs keep our bones from grinding against one another and provide shock absorption when we fall, exercise, and go about our daily lives. Damage to these discs can sometimes cause moderate or excruciating pain.

ACDF surgery may be performed on any disc between the seven bones of the cervical spine. It is typically necessary to fuse at least two bones during spinal surgery in order to ensure that the bones of the spine do not rub against one another.

A disc is replaced at this stage of the operation. By entering the neck from the throat, the surgeon can reach the spinal column easier. If the surgeon enters from the back, the neck muscles and spinal column can be injured. Once the surgeon obtains access to the spine, he or she will remove any damaged discs.

The space between the bony vertebrae is empty after the disc is removed. The open disc space is filled with a spacer bone graft to prevent the vertebrae from collapsing and rubbing together. By fusing the two vertebrae together, the graft serves as a bridge. Metal plates and screws are used to secure the bone graft and vertebrae.

The body begins to heal after surgery and new bone will grow around the graft. Approximately three to six months after the bone graft is placed, two vertebrae should grow into one solid piece of bone. In a similar fashion to reinforced concrete, the instrumentation and fusion function together.

Types Of Bone Grafts

Bone grafts are derived from numerous sources. There are advantages and disadvantages to each type:

Autograft Bone

Your bone is the source. In this procedure, your own bone cells are removed from the hip bone (iliac crest). Because it contains bone-growing cells and proteins, this graft has a higher fusion rate. The disadvantage is that you will have pain in your hip bone after the surgery. A bone graft is taken from your hip at the same time as spine surgery. It is not necessary to remove the entire thickness of bone during harvesting, just the top half layer.

Allograft Bone

This bone is obtained from a donor (cadaver). In bone banks, bones are collected from people whose organs are to be donated after death. Despite not containing any bone-growing cells or proteins, this graft is readily available and eliminates the need to harvest hip bone. The allograft is shaped like a doughnut and contains living bone tissue that is borrowed from your spinal column during surgery.

Bone Graft Substitute

Synthetic bone grafts are made of plastic, ceramic, or bioresorbable materials. This graft material, also called cages, contains slivers of living bone tissue that have been removed from your spine during surgery.

What Is ACDF Used To Treat?

If you have severe neck pain, weakness, or numbness that prevents you from engaging in normal daily activities, an ACDF may be right for you. If a physical examination indicates you have motion loss, abnormal sensation, or weakness that will likely improve with surgery, an anterior cervical discectomy with fusion maybe your best option.

ACDF is used to treat the following conditions:

  • Herniated Discs: A herniated disc is a spine condition in which the gel-like liquid leaks from the disc. The condition is also called a ruptured disc or slipped disc.
  • Degenerative Disc Disease: A damaged disc in the spinal column that results in neck pain and other symptoms.
  • Spinal Stenosis: A condition in which the vertebrae and surrounding nerves are compressed by a narrowing of the spaces in the spine.

An ACDF (Anterior Cervical Discectomy and Fusion) surgery is a highly recommended procedure for individuals experiencing chronic pain or neurological symptoms stemming from a damaged disc or other cervical spine issues. The benefits of opting for ACDF surgery extend beyond just pain relief. This procedure boasts a high success rate, with many patients reporting significant improvements in mobility and overall quality of life post-surgery. Furthermore, by removing the offending disc and fusing the adjacent vertebrae, the ACDF technique can effectively prevent further degeneration in the affected area, ensuring long-term spinal health. When conservative treatments fail to yield desired results, it’s crucial to consider the potential life-changing benefits of ACDF surgery. With the right medical guidance and post-operative care, this surgery can pave the way to a more active and pain-free life. For those keen on maximizing their chances of a successful recovery and returning to their daily routines unhindered, ACDF stands out as a top choice.

What to Expect After ACDF Surgery

After surgery in a non-outpatient setting, you can expect to be in the hospital for 2 to 3 days before going home. When there are more levels to treat, you would usually need to stay in the hospital longer. After undergoing an ACDF, the majority of patients need no rehabilitation. If you are being discharged from the hospital, you should be driven home by a family member or friend.

In most cases, oral pain medications are used to control postoperative pain. In the event that you feel that your pain is not controlled, you should request additional pain relief. X-rays will be taken the following day after your procedure. A routine scan is used to check the position of the spinal implants and the alignment of the spine. Following the operation, you may be prescribed antibiotics for up to 24 hours to minimize the risk of infection.

After surgery, you’ll usually have a wound drain that will be removed the following day. The nursing staff removes this drain in a painless manner. To prevent blood clots from developing in your calves (DVT), you will have stockings on your legs. Many patients will also be fitted with calf compression devices until they are able to move around.

Your diet will consist primarily of clear fluids at first. After the first 1 to 2 days, you can return to your regular diet. If you have a sore throat and difficulty swallowing, this is quite normal. Furthermore, It is not uncommon for patients to experience mild swallowing difficulties for several months. Experiencing these symptoms is due to your esophagus and larynx retracting, which causes inflammation. As time goes on, this will slowly improve. A change in the quality of a patient’s voice may also be noticed after surgery. In most patients, this improves with time, but in 1% of cases, it can last permanently.

Surgery Prevention

There is a high incidence of repeat episodes of neck pain. In order to prevent recurrence, you should do the following:

  • Use proper lifting techniques
  • Practice good posture during standing, sitting, walking, and sleeping
  • Adopt a balanced exercise routine
  • Try having an ergonomic workspace
  • Maintain a healthy weight and body composition
  • Use relaxation and positive thinking techniques
  • Avoid smoking

Alternatives to Surgery

After undergoing non-surgical treatments for several weeks, neck pain may resolve. Consider all non-surgical options before undergoing surgery. A few examples of alternatives to surgery:

  • Changing your activities or movements: There may be a repetitive movement that exacerbates your pain in your day-to-day activities. You can reduce the severity of your neck pain by avoiding activities that worsen it or by taking a brief rest period.
  • Medications: Pain and inflammation are often treated with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. If those measures do not work, your doctor may prescribe a short course of stronger pain medications or muscle relaxants.
  • Heat and cold therapy: In order to reduce swelling and relax painful muscles, ice packs or warm compresses can be used.
  • Physical therapy: You may be able to relieve pain and other symptoms by stretching and strengthening your spine.
  • Epidural steroid injections: Injections directly into the injured disc may create longer-lasting pain relief as well as reduced inflammation.

In the event that nonsurgical treatments aren’t making a significant difference, if your pain is debilitating, or if symptoms of spinal cord compression are worsening, speak with a Neurosurgeon today about ACDf Surgery.

Speak With A Florida Neurosurgeon Today

In our practice, there are three neurosurgeons that specialize in spine surgeries. In Florida, we have seven offices where our spine surgeons treat patients. Contact Florida Surgery Consultants to learn more about the benefits of choosing a neurosurgeon over an orthopedic spine surgeon.

ACDF General Questions and FAQs

There are many factors that come into play when it comes to the recovery of an ACDF surgery. Recovery time for an ACDF surgery is anywhere from 3 weeks to 3 months. Physical therapy and resting will generally speed up the recovery process.

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It depends on the type of work you do, if your job has lots of heavy lifting using your back you may not be able to return to that job. As for a simple desk job you may be able to return to work as early as 3 days.

Typically, the success rate for an ACDF surgery is around 75% for positive results.

After surgery, our nurses will schedule a post op appointment with our surgeon that performed the procedure. This is usually 2-3 weeks after your surgery.

Before surgery we ask you to stop taking anti-inflammatory medication at least 10 days before surgery. There are also some vitamins that you may want to avoid such as Vitamin K, fishoil, and CoQ10. Please give us a call to find out what other vitamins / medications you may want to avoid. 

A one level fusion does not limit much mobility, it is estimated that 5-7% mobility is lost. If there is more than a one level fusion, more mobility will be lost.

Generally, most people are able to get behind the wheel and drive after 1 to 2 weeks. Of course it also depends on the age of the patient and if the patient has been doing physical therapy. The younger the patient is and if the patient is doing physical therapy, the faster the patient will be able to return to driving.

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Glossary

initial segment of a nerve leaving the central nervous system

Nerve Root
Spinal Nerve Roots

Artificial or bone substitute that is used to repair your bone.

A Disc in your spine that has lost fluid becoming degenerative (collapsed disc)

Collapsed Disc MRI

Related Conditions

What Surgical Procedures do our Board Certified Spine Surgeons Perform?

Removes a herniated disc in the neck to relieve neck pain

Titanium implant to keep spine stabilized after a decompression surgery (removal of a disc herniation)

Device that gets implanted to replicate the function of a normal disc which replaces a damaged disc.

Removal of the lamina to relieve compression on the spinal cord.

Inject bone cement into the vertebrae to fix a compression fracture.

Surgeon goes in through the waist to relieve nerves that are pinched by removing damaged disc material.

Stabilizes the spinal vertebrae by going in through the back of the patient by creating a fusion with two or more vertebrae.

Removal of a herniated disc or parts of the disc to relieve spinal cord pressure

Removes damaged disc material and fuses the vertebrae together

Reduces a disc herniation with laser technology

Fuses Sacrum and Ilium to create one immobile joint which helps with back pain

Our Neurosurgical Spine Surgery Team

Currently on staff, we have three Neurosurgeons that specialize in spine surgery. Our Spine Surgeons see patients in all five of our office locations in Florida. To find out more on why patients should choose a neurosurgeon for spine surgery rather than an orthopedic spine surgeon click here. If you want to see their credentials click their profiles. 

Neurosurgeons close to me

Dr. Jonathan Hall, MD

Board Certified Neurosurgeon - Minimally Invasive Spine Surgery

Florida Surgery Consultants New Neurosurgeon Dr. Donna Saatman

Dr. Donna Saatman, MD

Board Certified Neurosurgeon - Minimally Invasive Spine Surgery