Anterior Cervical Discectomy
and Fusion

What Is It?

An anterior cervical discectomy and fusion (ACDF) is a surgical procedure of the spine in the neck. It is a very common procedure to access the discs in the neck. While the name sounds complicated, we will take it apart one work at a time which will help explain what it is.

Anterior refers to the front of the body. This procedure is performed through the front of the neck, generally through a horizontal incision to one side of the mid-line. Cervical refers to the neck region of the spine. A discectomy is the removal of an intervertebral disc, the cartilaginous soft tissue between the bones of the spine. Finally, a fusion is a procedure that attempts to fuse two or more levels of the bony spine into one unit which does no not move independently, basically creating a single bone out of one or more.

So the surgeon uses an incision in the front of the neck to access the front size of the spine. The disc is opened and removed from the front and then a fusion is undertaken. Generally, the fusion part involves placing a graft of bone or bone substitute in the disc space after the disc is removed. This helps act as a support and to supply a scaffolding for the body to fuse the bone across the gap. While in the past this was all that was done, now a metal or synthetic plate is usually placed across the gap and held in place with bone screws to help stabilize the fused segment.

Over time, if the fusion is successful, the involved levels will fuse with bone across them so that they do not move independently.

What Is It Used For?

There are several possible indications for an anterior cervical discectomy and fusion. Most commonly it is used for a cervical herniated disc. These discs cannot generally be removed from the back because in the cervical region the spinal cord is large and blocks the approach from the rear. The anterior approach used in an anterior cervical discectomy and fusion is the safest and most direct route to the herniated disc.

If more than one disc is being treated, a multi-level ACDF can be done.

Additionally, in some forms of cervical stenosis the optimal approach may be from the front. An ACDF with or without corpectomies (removal of the vertebral bodies from the front in addition to the discs) can help to decompress the stenotic spinal canal.

Success rates, potential complications and recovery time all vary considerably depending on the specifics of each case.

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Important Note: This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.

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