At a glance
What it is
Neck surgery that removes a damaged disc to relieve pressure on the spinal cord or a nerve root, then fuses the level with a bone graft or implant.
What it treats
Symptomatic cervical disc herniation, cervical degenerative disc disease, bone spurs from arthritis, and cervical spinal stenosis.
How it's done
Under general anaesthesia, through a small incision at the front of the neck, using an operating microscope.
What is an anterior cervical discectomy and fusion?
Anterior cervical discectomy and fusion (ACDF) is a type of neck surgery that removes a damaged disc to relieve spinal cord or nerve root pressure and the pain, weakness, numbness and tingling that come with it. A discectomy is a form of surgical decompression, so the procedure may also be called an anterior cervical decompression.
The operating microscope's magnification lets the neurosurgeon work through a small skin incision in the neck. The surgery has two parts:
- **Anterior cervical discectomy.** The spine is approached through the front (anterior) of the neck, and the disc is removed from between two vertebrae. - **Fusion.** Done at the same time to stabilise the segment: a bone graft and/or implant is placed where the disc was, to provide stability and strength.
While ACDF is most commonly done for a symptomatic cervical herniated disc, it may also be done for cervical degenerative disc disease, to remove bone spurs (osteophytes) caused by arthritis, and to relieve the symptoms of cervical spinal stenosis.
Why the anterior approach?
ACDF is performed through the front of the neck rather than the back. This approach has two typical advantages.
Access
Direct access to the disc
- Direct view of the cervical discs, which usually cause the spinal cord or nerve compression.
- Removing the disc directly decompresses the nerve and spinal cord.
- Reaches almost the whole cervical spine, from C2 down to the cervicothoracic junction (C7–T1).
Recovery
Less postoperative pain
- A relatively uncomplicated pathway to the spine.
- Only one thin muscle needs to be cut; natural tissue planes are followed down to the spine.
- Patients tend to have less pain than after an operation from the back.
Description of the surgery
Before surgery, intravenous antibiotics are given to reduce the risk of infection. You are anaesthetised while lying on your back, and your head is placed in a special head-holder.
The surgery is performed through a small incision on the right or left side of the neck over the diseased disc or discs. The surgeon works down to the cervical spine by gently moving the carotid artery to one side and the oesophagus and trachea to the other. The disc level is confirmed with an X-ray, and the microscope is used for the rest of the operation.
Careful micro-dissection allows the disc to be removed. The neurosurgeon can then see and remove bone spurs pressing on the nerve or spinal cord, and checks that no other disc fragments remain. The wound is irrigated with antibiotic solution.
A bone graft (usually from the bone bank) or a PEEK spacer with autograft bone is placed in the disc space. Often a titanium plate is fixed to the front of the spine with screws into the vertebrae above and below to maintain alignment.
After the operation
Absorbable stitches close the incision under the skin, with stitches or skin glue on the surface and a sterile dressing on top. A hard or soft cervical collar may be needed after surgery; if so, it is fitted at the end of the operation. The breathing tube is removed and you are taken to the recovery room.
Related at Alimran Medical Center
Spine surgery
Conditions
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This page describes a treatment offered at Alimran Medical Center and is not a substitute for individual medical assessment. Suitability is decided in consultation.