Cervical Spine/Neck Pain Surgery: Anterior Cervical Discectomy and Fusion (ACDF)

What is ACDF?

ACDF is the most common surgery for neck pain. It is a procedure that removes a damaged disc in order to relieve spinal column or nerve root pressure, which eases pain.

ACDF is performed to relieve pain in patients who:

  • Have significant arm pain
  • Experience weakness in the hand or arm
  • Have pain that does not resolve after several months
  • Have pain that does not go away after less-invasive treatment
  • Have been diagnosed with herniated or degenerative discs, and the condition has not healed after several months

Typically, surgeons access the cervical spine from the front of the neck, because using this anterior approach, the disc can be reached without disturbing the spinal cord, spinal nerves, and the strong neck muscles. The neurosurgeon will then remove the degenerated disc.

The space left by the absent disc then becomes empty. To prevent the vertebrae from collapsing and rubbing together, the space is filled with bone or other material. The material 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. After surgery, new bone cells will grow around the graft, as part of the body’s natural healing process. After three to six months, the two vertebrae should be joined together as one solid piece of bone. This provides greater stability to the cervical spine.


Recovery from ACDF

Some patients go home the day of the procedure, although many may have to stay overnight.

Your neurosurgeon will provide specific instructions for your recovery, but in general:

  • Your pain will be managed with prescription medications.
  • You should avoid showering for the first few days.
  • Do not drive for two to four weeks after surgery or until discussed with your surgeon.
  • Avoid sitting for long periods of time.
  • Avoid bending your head forward or backward.
  • Climbing stairs is permissible if it’s comfortable
  • Get plenty of sleep. You may be more comfortable in a reclining position rather than lying flat.
  • Many patients experience hoarseness or a sore throat. This is normal, and the symptoms will resolve within a few weeks.
  • Walk as much as you are able to help your recovery.
  • Do not lift anything heavier than five pounds.
  • Avoid housework such as vacuuming, ironing, laundry, and loading and unloading the dishwasher, until your first follow-up office visit following surgery.
  • Postpone sexual activity until your follow-up appointment unless your surgeon specifies otherwise.