Anterior Cervical Diskectomy and Fusion (ACDF)

Anterior Cervical Diskectomy and Fusion (ACDF) is a surgical procedure used to treat patients with a compressed nerve or compressed spinal cord who do not improve with conservative care.  If a patient has a compressed spinal cord and exhibits any symptoms, they will most likely need to undergo surgery regardless of their response to conservative care.  The reason being that conservative care will be unlikely help improve their symptoms.  In terms of surgery, the incision is made in the front of the neck, usually in a skin fold horizontally. After the incision, there is a “natural” plane towards the anterior spine making access easy and usually the reason most patients do not have a lot of postoperative pain. The mainstay of the surgical procedure is for the surgeon to remove the disc to allow access to the spinal cord and spinal nerves. Once the disc is removed, the surgeon can free up the compressed nerve or spinal cord to provide relief.  Since there is no disc remaining, the surgeon usually replaces it with a spacer and secures the spacer with a plating system. The spacer can be cadaver bone, your bone, PEEK (plastic or poly-ether-ether-ketone), or titanium cage. Titanium is compatible with MRI, CAT Scan or X-Ray.  The spacer is secured with a plate or similar device to add stability to the construct. The procedure described is a fusion and will cause the vertebral body or bone above and below the disc to grow together in bony union.  Some patients are concerned about a fusion as they are afraid that it will cause more damage as they become older, but the data is still early.  The surgical procedure is similar to an Anterior Cervical Disk Replacement (ACDR) in that both procedures remove the pressure from the nerves but unlike the ACDR, the ACDF is a fusion procedure of adjacent segments and does not allow motion. The ACDF can be done at any number of levels of the cervical spine.