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Anterior cervical discectomy and fusion, often abbreviated ACDF, is a regularly performed procedure that treats many cervical spine (neck) disorders. An ACDF is usually performed to address a herniated disc in the neck or a degenerated disc. The most common disc-related issues are disc degeneration and herniation, both of these may compress the spinal cord that resides within the spinal canal or the spinal nerve roots.

Common symptoms treated with ACDF may include neck, shoulder, upper back, and/or arm pain. Other neurologic symptoms may include tingling, weakness and numbness in the hands or arms. The intention of an ACDF is to alleviate symptoms, decompress the nerve root(s) and spinal cord, secure the neck and, in turn, allow the patient to return to their everyday activities of daily living.

About Cervical Discectomy

ACDF is performed under general anesthesia. The neck is prepared for surgery by being thoroughly cleaned, after this, an incision is made on the left or right side of the neck. To expose the disc the tissues and muscles are gently and carefully pulled aside. Dr. Stieber uses a type of real-time x-ray during surgery, this is called fluoroscopy. Various specially-designed surgical instruments are used to remove the ruptured or herniated disc. The vertebral bodies are gently separated and the original height is restored between the vertebrae. The disc herniation and bone spurs (osteophytes) that are compressing or pinching the spinal nerve roots are carefully removed. Bone graft fills the space after discectomy.

Types of Bone Graft

  • Local Autograft is used, when possible, by recycling the bone that is removed from the ends of vertebral bodies during the normal process after discectomy when the bony endplates of the vertebra are smoothed and flattened.
  • Iliac Crest Autograft is the patient’s own bone; it is normally taken from the hip through a tiny incision.
  • Allograft is donor bone from a bone bank.
  • Bone graft substitute; there are different types, some of which are synthetic (man-made) and available in different shapes.
Anterior Cervical Discectomy and Fusion
Anterior Cervical Discectomy and Fusion Pre and post operative x-rays of a 49 year old female who was treated with an ACDF

After Surgery

The patient is moved into the recovery area after the surgery. Our nurses and other members of the medical team closely monitor the patient’s vital signs, this would include the patient’s respiration, pulse, blood pressure, and level of pain. There is some post-operative pain that should be expected and patients will receive pain medication either through their IV (intravenous line) or by mouth.

Dr. Stieber provides ACDF patients with instructions about what to expect and self-care after hospital discharge. This information includes information about ways to manage any pain, medications, bathing and incision care, activity restrictions, and surgical follow-up appointments. As always, Dr. Stieber and his staff welcome questions and ensure that all patient concerns are thoroughly addressed.

  • A post-operative cervical brace may be prescribed to wear for a period of time after surgery to help immobilize and support the neck while healing.
  • Many patients may go home on the same day as surgery. Dr. Stieber will go over the likelihood of hospitalization with patients before their surgery date.

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