A Visual Guide to Anterior Cervical Discectomy and Fusion (ACDF) Surgery

If there's a problem with one of the discs in your cervical spine (neck)—such as degenerative disc disease or a cervical herniated disc—the resulting pressure on the nerves may cause pain, weakness, or tingling along your shoulders and arms.

See Radiculopathy, Radiculitis and Radicular Pain

In some cases, your doctor may recommend a procedure called an anterior cervical discectomy and fusion (ACDF) to help relieve the pain. This procedure removes the damaged disc and stabilizes the spine by fusing the vertebrae adjacent to the disc together.

To begin, your surgeon will make a 1- to-2 inch incision in the front of your neck.

See Anterior Cervical Decompression and Spine Fusion Procedure

To access your spine, your surgeon will cut and move aside the muscle and other soft tissue that covers your spine. This will expose the disc that the doctor is targeting for removal.

See Cervical Spine Anatomy and Neck Pain

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Using X-ray guidance, your surgeon will confirm that he or she has located the correct disc by inserting a needle into the disc space.

The surgeon then makes an incision in outer coating of the disc, called the annulus fibrosus, in order to access and remove the soft, inner core of the disc, called the nucleus pulposus.

See Spinal Discs

This is a view from above, showing a disc that has been mostly removed. As you can see, a small portion of the disc (shown here in purple) may be left intact.

A ligament may need to be removed to access the spinal canal and remove any bone spurs or disc material that is pushing on the ligament.

See Bone Spurs (Osteophytes) and Back Pain

Next, a bone graft or a cage, like this one shown above, is inserted into the space where the disc used to be. The insert prevents the disc space from collapsing.

See Bone Graft for Spine Fusion

The surgery itself doesn't create a fusion—that occurs as the bone regrows after surgery. The implant will allow the bone to grow together between the 2 vertebrae, creating a bony bridge, or a fusion.

Watch: Back Surgery Video: How Spinal Fusion Stops Back Pain

The surgeon will typically affix a small metal plate to the upper and lower vertebrae to provide stability while the bone fusion heals. Total healing can take up to 18 months.

Learn more:

Postoperative Care for Spinal Fusion Surgery

Potential Risks and Complications of ACDF Surgery

Anterior Cervical Discectomy and Fusion (ACDF) Video won a silver Telly in 2015.

Watch: Anterior Cervical Discectomy and Fusion (ACDF) Video

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