What is an ACDF?

What is an ACDF?

ACDF is an acronym for Anterior Cervical Diskectomy and Fusion. Previously, it was known as an ACDFP or Anterior Cervical Diskectomy, Fusion & Plating. Over the past decade, the traditional allograft construct and plate have been replaced by a synthetic interbody implant with a screw system built directly into the device. The benefit of not using a plate is for a few reasons. First, the plate takes more time to secure onto the spine and second, there is less scar tissue making swallowing after surgery less difficult.

The goal of an ACDF is to remove a disc herniation or bone spur compressing either the spinal cord or nerve root. If the spinal cord is compressed, patients may have symptoms of myelopathy commonly causing hand weakness or numbness. If a nerve root is compressed, patients may have symptoms of radiculopathy commonly causing arm pain, weakness, or numbness. There are some cases where the procedure is done for severe degeneration of the cervical spine causing neck pain.

During the procedure, a small, horizontal incision is made just off the midline of the anterior neck. Surgeons dissect down to anterior cervical spine until the vertebral body and disc space are located and then confirmed with X-Ray. The disc is cut and removed with a series of curettes (cupped instruments) and other instruments such as a rongeur. The operating microscope is then used to view the area deep to the disc space to decompress either the spinal cord, nerve root, or both.

After decompression, surgeons insert a spacer (commonly called a cage) usually made of PEEK (Poly-Ether-Ether-Ketone) to replace the disc material that was just removed. Prior to insertion, we place your own bone into the center of the cage to promote further healing and subsequent fusion. After placement, the PEEK Cage is secured with titanium blades. In my practice, I have been using the LDR-C ROI Cervical implant for the past 10 years with excellent results. There is a short video to view here. During surgery, we monitor your nerves and spinal cord using Intraoperative Monitoring.

The incision is closed and patients are taken to the recovery room. Most patients spend approximately one hour in the recovery room and then taken to the Same Day Unit (SDU) for further observation for a few hours. You do not need to wear a collar after surgery. Patients are usually discharged home the same day of surgery.