An anterior cervical discectomy and fusion (ACDF) is a procedure used to treat cervical herniated discs by surgery through the front of the neck. The procedure is actually made up of two parts, the discectomy which removes the herniated disc, and the fusion to stabilize the cervical segment. While this surgery is most commonly done to treat a symptomatic cervical herniated disc, it may also be done for cervical degenerative disc disease. It is also commonly done to remove bone spurs associated with cervical spinal stenosis and arthritis. Discectomy literally means "cutting out the disc." A discectomy can be performed anywhere along the spine from the neck (cervical) to the low back (lumbar).
Dr. Walpert will reach the damaged disc from the front (anterior) of the spine through the throat area. By moving aside the neck muscles, trachea, and esophagus, the disc and bony vertebrae are exposed. Surgery from the front of the neck is more accessible than from the back (posterior) because the disc can be reached without disturbing the spinal cord, spinal nerves, and the strong neck muscles. Depending on your particular symptoms, one disc (single-level) or more (multi-level) may be removed.
After the disc is removed, the space between the bony vertebrae is empty. To prevent the vertebrae from collapsing and rubbing together, a spacer bone graft is inserted to fill the open disc space. The graft serves as a bridge between the two vertebrae to create a spinal fusion. The bone graft and vertebrae are fixed in place with metal plates and screws. Following surgery the body begins its natural healing process and new bone cells grow around the graft. After 3 to 6 months, the bone graft should join the two vertebrae and form one solid piece of bone. The instrumentation and fusion work together, similar to reinforced concrete.
After the procedure, you may be released to go home the same day or may stay overnight for monitoring. Typically you won’t need to stay any longer than one night and should be able to return home relatively soon. A cervical collar or brace is sometimes worn during recovery to provide support and limit motion while your neck heals or fuses. Exercises may be prescribed to help you regain full motion and to facilitate healing.