Anterior Cervical Discectomy and Fusion (ACDF)

Anterior cervical discectomy and fusion (ACDF) is a common form of spinal fusion used in the cervical spine (neck) for treating neck pain, cervical radiculopathy or myelopathy, spinal fractures, cervical spondylolisthesis, and other cervical spine disorders. The surgery is performed from the front of the neck. It has the advantage of less pain and a quicker recovery than similar operations performed from the back (posterior) side of the neck.

The procedure begins with a short incision off to one side of the neck. I dissect down to the front of the spine and then accesses the disc between two neighboring cervical vertebrae. The disc is removed, and a metal implant and bone graft are introduced between the vertebrae to encourage bone to grow between them.

Below is a view of the cervical spine from the front showing the vertebrae and the discs between them. One or more of these discs is removed in an ACDF.

ACDF can be a very effective procedure for the right patient. Most patients are able to return home and resume most normal activities almost immediately. Risks include difficulty in swallowing, voice hoarseness, and bleeding (neck hematoma), among others. I try to avoid the procedure (and other spinal fusions) in patients who are heavy smokers, because smoking is known to reduce the rate of successful fusion. You should have a discussion with your doctor about whether this is the right procedure for your symptoms.