What is ACDF?

ACDF stands for anterior cervical discectomy and fusion, which is a surgical procedure usually performed on patients who have neck or arm pain because of a damaged disc in the neck. The procedure is also done to stabilize the bones of the neck, in order to prevent injury to the spinal cord. Surgery is normally done after less invasive methods of treatment, such as physical therapy and medications, have been unsuccessful in treating pain or stabilizing the injury.

The term cervical means neck, and the cervical vertebrae are the top seven bones of the spinal column that run from the skull to the top part of the back. Between each vertebra is a disc, which is a doughnut-shaped tissue filled with a cushioning gel that allows the bones to move without rubbing against each other. When the disc becomes damaged, the gel leaks into the surrounding body cavities, pressing on nerves and creating pressure and pain. Discs can become damaged from a traumatic injury such as a car accident, or can be damaged as a result of degenerative disc disease, scoliosis, or other conditions that cause misalignment of the spine. Discectomy is surgical removal of the damaged disc.

ACDF describes a surgical procedure where the surgeon removes the disc through the front, or anterior, part of the neck. An incision is made in the throat, and the esophagus and trachea are pushed aside so that the surgeon can remove the disc. The surgery is similar to PCDF, or posterior cervical discectomy and fusion, where the surgeon removes the disc from the back of the neck.

ACDF is a more common procedure because it is less painful than PCDF, which requires cutting into spinal nerves and the thick muscles in the back of the neck; ACDF also carries a lower risk of damaging the spinal cord during the surgery. The goal of both surgeries is to remove the damaged disk and stabilize the neck bones, and in some cases both procedures are required.

After the damaged disk is removed, a fusion is performed. Fusion describes several different methods for connecting two or more bones together to form one continuous bone. The surgeon will often stabilize the area using metal plates screwed into the bones, which maintains the alignment and space between the vertebrae. A graft is sometimes performed, in which the surgeon fills in the space with the patient's own bone, harvested from the hip, or donor bone harvested from cadavers. Over time, the patient's body will grow new bone between and around the graft, further strengthening the fusion.

ACDF usually requires a hospital stay lasting a few days, unless complications require further observation. Recovery at home lasts between four to six weeks, during which the patient will normally wear a neck brace or cervical collar to maintain the position of the neck while it is healing. As with any surgical procedure, complications may include reaction to anesthesia, infection, or rejection of the graft. Some patients report a slight loss of ability to move their head from side to side or up and down. However, most patients report that the relief of pain is worth the slight loss of mobility resulting from the surgery.