ACDF (Anterior Cervical Discectomy and Fusion)

Overview

ACDF — Anterior Cervical Discectomy and Fusion — is one of the most successful and well-studied procedures in all of spine surgery. It is the gold standard treatment for cervical disc herniations causing arm pain, weakness, or spinal cord compression (myelopathy) that has not responded to non-surgical treatment. Dr. Basques performs ACDF through a small incision in the front of the neck. The damaged disc is removed to decompress the spinal cord and nerve roots, a spacer (cage) packed with bone graft is placed in the disc space to restore height and alignment, and a small titanium plate with screws provides immediate stability while the bone fuses. ACDF has a 90–95% success rate for relieving arm pain from cervical disc herniation. Dr. Basques has performed hundreds of ACDF procedures and is a recognized expert in both single-level and multi-level cervical reconstruction.

How It Works

Under general anesthesia, a horizontal incision (about 2–3 cm) is made in a natural skin crease in the front of the neck. Dr. Basques carefully retracts the trachea, esophagus, and carotid artery to expose the front of the cervical spine. Using a surgical microscope for magnification, the damaged disc is completely removed. Any bone spurs or disc fragments compressing the nerves or spinal cord are also removed. The disc space is prepared, and a cage packed with bone graft material is inserted to restore normal disc height and alignment. A thin titanium plate is placed over the front of the vertebrae, secured with small screws. The retractors are removed, and the neck structures return to their natural position. The skin incision is closed with dissolving sutures. The procedure takes about 60–90 minutes for a single level.

Benefits

Who Is a Candidate?

Ideal candidates have cervical disc herniation causing arm pain, numbness, or weakness that has not responded to 6–8 weeks of non-surgical treatment; cervical myelopathy (spinal cord compression); cervical radiculopathy with progressive neurological deficits; or cervical degenerative disc disease with foraminal stenosis. Patients with significant facet arthritis, multi-level disease, or kyphotic deformity may also be candidates. Dr. Basques performs a comprehensive evaluation including MRI, X-rays, and physical examination to determine if ACDF is right for each patient.

Recovery & Aftercare

Most patients stay overnight in the hospital and go home the next morning. A soft collar may be worn for comfort for a few days. A mild sore throat is common for 1–3 days and resolves with throat lozenges and soft foods. Light activities resume within 1–2 weeks. Return to desk work is typically 2–3 weeks. Heavy lifting and contact sports are restricted for 3–6 months while the fusion solidifies. Most patients notice dramatic arm pain relief immediately after surgery. Dr. Basques provides a detailed recovery protocol.

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