Cervical Spine
Anterior Cervical Discectomy & Fusion (ACDF)
A reliable operation for cervical disc herniation, radiculopathy, or myelopathy.
What it is
ACDF is a workhorse cervical-spine operation. Through a small incision in the front of the neck, the diseased disc is removed and replaced with an interbody spacer. A small plate or integrated cage holds the segment in place while bone fusion completes over the following months.
It addresses the source of the problem directly — the disc that's compressing the nerve or spinal cord — rather than just decompressing around it.
Why this procedure when surgery is needed
For cervical radiculopathy or myelopathy that has not improved with conservative care, ACDF offers reliable relief of arm pain and stabilization of neurologic symptoms. It has decades of outcome data behind it.
For most patients with single- or two-level disease, the trade-offs (small loss of motion at the operated levels, durable nerve decompression, structural stability) are favorable.
What to expect
Surgery takes 1–2 hours per level.
Most single-level patients go home the same day. Two-level cases often stay one night.
Mild sore throat and difficulty swallowing for a few days is normal.
Return to desk work in about 2 weeks. Driving when off narcotics.
Bony fusion completes over 3–6 months. Imaging at follow-up confirms.
Approach
- Anterior cervical approach through a small transverse neck incision
- Operating microscope for nerve and cord visualization
- Allograft or PEEK interbody cage with anterior plate or integrated fixation
- Intraoperative fluoroscopy or navigation for precision
- Multimodal pain control to minimize opioid need
Typical indications
- Cervical radiculopathy with imaging-correlated nerve compression unresponsive to conservative care
- Cervical myelopathy with progressive symptoms
- Cervical disc herniation causing weakness
- Cervical instability or post-traumatic deformity
Alternatives we considered
- Cervical disc arthroplasty (motion preservation) for select single-level disc patients
- Posterior cervical foraminotomy for select lateral-only nerve compression
- Continued conservative care if symptoms are stable and not progressive
- Posterior decompression + fusion for multi-level myelopathy
Related conditions
This procedure is most often performed for:
Videos for this procedure
- Preparing for Your Spine Surgery (Ages 50–65)(in production · 9 min)
- ACDF (Anterior Cervical Discectomy & Fusion)(in production · 7 min)
Last reviewed: 2026-05-09· Author: Chad Tuchek, MD · Cotton O'Neil Neurosurgery and Spine Center, Stormont Vail Health
The information on this page is general patient education and is not a substitute for individualized medical advice. For urgent symptoms, call 911 or go to the nearest emergency department. For non-urgent questions, call (785) 368-0767.