ACDF Spinal Fusion Surgery – the Basics

ACDF stands for Anterior cervical discectomy and fusion. ACDF spinal fusion surgery will remove any degenerative or herniated disc in your neck. The surgeon will make a small incision in your throat area to reach in and remove the problem disc. They’ll then insert a graft that fuses together with the bones located below and above the disc. This surgery might be an option for you if medications or physical therapy doesn’t relieve your arm or neck pain caused by pinched spinal nerves. You’ll typically go home the same day you have your ACDF spinal fusion surgery.

Defining an Anterior Cervical Discectomy and Fusion

The definition of discectomy is cutting out the disc. Your surgeon can perform ACDF surgery anywhere along your spine. It can start at the cervical portion of your spine and go to the lumbar region in your lower back. The surgeon will reach your damaged disc through the front of the spine through your throat. They’ll move aside the trachea, muscles, and your esophagus to expose your bony vertebrae and the disc in question.

Having surgery from the front of your neck is much more accessible than having it from the back because the surgeon is allowed to reach the damaged disc without disturbing your spinal nerves, neck muscles, or the spinal cord itself. They could remove a single-level disc or multi-level disc, depending on your symptoms.

Once they remove the disc, it leaves an empty space between your bony vertebrae. They’ll insert a spacer bone graft to prevent the surrounding vertebrae from collapsing and rubbing. The graft will fill in this open space to serve as a bridge between the leftover top and bottom vertebrae. Eventually, this will form a spinal fusion.

The surgeon will fix the vertebrae and bone graft in place using screws and metal plates. The body will start the natural healing process with the new bone cells growing around the graft. After three to six months pass, the bone graft should connect the two vertebrae that were left after they removed the damaged disc, and you’ll get one solid piece of bone. The fusion and instrumentation work together just like reinforced concrete does.

Your bone graft in an ACDF surgery can come from several places. Each source has benefits and drawbacks associated with it, including: 

  • Allograft Bone – This bone comes from a cadaver. The bone bank will collect these grafts from organ donors after they die. The graft doesn’t have bone-growing cells or proteins in it, but it’s readily available while eliminating the need to harvest bone from you. This bone is shaped just like a doughnut, and they pack the center with shavings of living bone tissue that they take from your spine while they’re performing surgery.
  • Autograft Bone – This bone comes directly from you. A surgeon will take your bone cells directly from your hip. You’ll get a higher fusion rate with this option because it contains proteins and bone-growing cells. However, you’ll have pain in your hip after surgery because they’ll harvest these cells at the same time they do your ACDF surgery. They harvest a half-inch thick piece of bone.
  • Bone Graft Substitute – This graft material uses a man-made plastic, bioresorbable compounds, or ceramic. Better known as cages, they pack this graft material with living bone tissue they harvest from your spine during the surgical procedure.

After you have your surgery, you could have a slight range of motion loss. However, this will vary according to your neck mobility before surgery and how many levels they fused. If they only fused a single level, you could have a better or similar range of motion than before you had the surgery. If they fused more than two levels, you could have limits on how far you can look up and down or turn your head.

Another option is motion-preserving artificial disc replacements. This is very similar to a knee replacement. They insert an artificial disc into the damaged space to help preserve your range of motion. The outcomes for this surgery are similar to ACDF surgery, but they haven’t proven the long-term results yet. You should talk with your surgeon to see which is best for your situation.

Good Candidates for ACDF Surgery

If you meet the following criteria, you could be a good candidate for this surgical procedure. The biggest criteria include but are not limited to:

  • Arm pain that is worse than your neck pain
  • Diagnostic tests like CT scans or an MRI show that you have a degenerative or herniated disc
  • Significant weakness in your arm or hand
  • Symptoms haven’t improved with medication or therapy

Recovery from ACDF Surgery

You want to schedule an appointment to follow up with your surgeon two weeks after you have your surgery. Your recovery time generally falls between four and six weeks. The surgeon may recommend x-rays after several weeks to help verify that the bones are fusing. The surgeon will decide when you’re healed enough to go back to work when you go to your visit to follow up with them.

Your surgeon may recommend a brace or cervical collar to limit your motion and provide support while you recover. They may also direct you to do neck exercises and stretches or physical therapy when you heal. If the graft came from your hip, you could experience soreness, pain, and stiffness around the incision site. Get up every 20 minutes and walk or move around.

Contact Florida Spine Associates for Information on ACDF Surgery

If you think that you are a good candidate for ACDF spinal fusion surgery, contact us for a consultation. We’ll sit down with you and discuss your symptoms, pain levels, potential treatment options, and answer all of your questions. We’re ready to help in any way we can.