Anterior Cervical Discectomy and Fusion
Anterior cervical discectomy and fusion, often abbreviated as ACDF, is a common procedure performed in the cervical spine. It involves an incision along the front of your neck (called the anterior side) in order to remove disc material and access your spinal cord and nerve roots. The procedure involves removing the disc (the discectomy portion of the operation) in between the two bones and placing material in that space which allows those two bones to grow together (the fusion portion of the operation). A plate and screws may also be placed on top of the bones in your neck to hold the 2 together until they can fuse.
The surgery is most commonly done to treat a herniated cervical disk which is irritating a nerve and causing neck, shoulder, arm and hand pain or numbness. The surgery is also done to treat cases where bone spurs are causing tightening around the spinal cord (also known as cervical stenosis).
The procedure itself involves a one to two inch incision skin incision on either the left or right side of your neck, usually placed horizontally in line with a naturally occurring skin crease. The thin muscle underneath is divided and then the plane in between your esophagus and carotid artery developed down to the front of your spine. An x-ray is then taken to ensure we are at the appropriate disc space and then the disc material is removed using a variety of instruments. Any remaining bone, ligament etc… is removed to fully relieve any pressure on the spinal cord or nerve roots. Following this, either bone graft or possibly an implant is placed into the evacuated disk space to allow for fusion of the 2 bones together and to prevent collapse of the disk space. A small plate is then attached to the front of the spine and screws placed to hold the plate in place. This serves to make the construct more rigid and hold the 2 bones together until they have had a chance to grow together.
Approaching the cervical spine from the front allows for a few advantages as compared to the back or posterior approach. It allows for less muscle stripping as compared to approaches from the back side and frequently less incisional pain. It also allows for direct access to any herniated disc fragments which may be causing nerve irritation. There are always potentials risks to each type of procedure and no 2 surgeries are the same, so be sure and speak to your physician about your specific risk profile.