What is ACDF Surgery?
ACDF (Anterior Cervical Discectomy and Fusion) is the most commonly performed cervical spine surgery. Through a small 3–4 cm incision on the front of the neck, the diseased cervical disc is removed (discectomy), the spinal cord and nerve roots are decompressed, and a bone graft or titanium cage is inserted in the disc space to restore disc height and allow fusion of the two vertebrae.
A titanium plate and screws are secured to the front of the vertebrae to provide immediate stability while fusion occurs over 3–6 months. ACDF consistently achieves excellent outcomes for arm pain, numbness, and hand weakness — with success rates exceeding 90% for single-level disease.
Indications for ACDF
- Cervical radiculopathy — disc herniation causing arm pain, numbness, or weakness not responding to 6–12 weeks of conservative treatment
- Cervical myelopathy — spinal cord compression causing hand clumsiness, gait imbalance, or limb weakness
- Cervical spondylotic myelopathy — cord compression from spondylosis and osteophytes
- Failed conservative management including physiotherapy and injections
The Procedure
Incision & Approach
3–4cm horizontal incision on the right or left side of the neck. Natural tissue planes used — no muscle cutting required. Trachea, oesophagus, and carotid retracted to expose the front of the cervical spine.
Discectomy
Diseased disc removed under microscope. Osteophytes trimmed. Posterior longitudinal ligament opened to expose the dura. Spinal cord and nerve roots fully decompressed.
Cage & Bone Graft
Titanium or PEEK cage packed with bone graft inserted into the disc space to restore height and promote fusion. Anterior cervical plate and screws applied for immediate stability.
Recovery
Patient mobilised day 1. Soft cervical collar worn for 6 weeks. Discharged day 2–3. Light work in 2–4 weeks. Full fusion at 3–6 months.
ACDF vs Cervical Disc Replacement
For young patients (<55 years) with single-level soft disc herniation and no instability, cervical disc replacement (CDR) may be preferred — preserving neck motion at the operated level and reducing adjacent segment disease. Dr. Chugh will advise whether ACDF or CDR is more appropriate for your specific anatomy and pathology.