Anterior Cervical Discectomy and Fusion (ACDF)
A clear, patient-centered guide to what Anterior Cervical Discectomy and Fusion (ACDF) is, when it is recommended, how the procedure is performed, and what to expect during recovery—designed to help you understand the path toward relief of pain, numbness, or weakness related to nerve compression.
Cervical decompression + stabilization
Anterior (through the front of the neck)
Remove disc/bone spurs & decompress nerves
Gradual return to activity (individualized)
What is ACDF?
Anterior Cervical Discectomy and Fusion (ACDF) is a cervical spine procedure in which the problematic intervertebral disc (and, when needed, bone spurs) is removed to decompress spinal nerves and/or the spinal cord, followed by fusion to stabilize the treated segment.
Fusion allows the involved vertebral levels to “grow together” over time, forming a stable unit. The goal is to relieve symptoms such as arm pain (radiating pain), numbness/tingling, weakness, and—in selected cases— balance or walking difficulties related to spinal cord compression.
Why is ACDF recommended?
ACDF may be recommended when non-surgical treatments have not provided adequate relief and symptoms significantly affect quality of life—such as arm pain, numbness/tingling, weakness, and/or signs of spinal cord compression.
Common indications
- Cervical disc herniation causing nerve root compression (radiculopathy)
- Cervical spinal canal stenosis and/or spinal cord compression (myelopathy)
- Bone spurs/degenerative changes associated with neurologic symptoms
- Persistent symptoms despite conservative care (physical therapy, medications, and injections when appropriate)
How your plan is individualized
- Correlation of symptoms with MRI/CT findings and neurological examination
- Selection of the appropriate level(s) and surgical objective (decompression/stabilization)
- Discussion of alternatives and realistic goals (pain relief, strength, function)
- Tailored recovery guidance based on your work demands and daily activities
Before surgery
Preparation is focused on maximum safety and a clear understanding of the “why,” the “how,” and what to expect. Your instructions are individualized based on your medical history and diagnosis.
Clinical evaluation
Neurologic examination, symptom assessment (pain/sensation/strength/balance), and goal setting.
Imaging & surgical planning
MRI/CT/X-rays as needed to precisely match imaging findings with symptoms and select the appropriate level(s).
Pre-operative testing
Laboratory testing, anesthesia evaluation, medication review, and personalized pre-op instructions.
Recovery planning
Arranging transportation/support at home, activity guidance, and a follow-up plan.
How is ACDF performed?
The procedure typically follows a well-defined sequence: an anterior approach, removal of the disc and any compressive bone spurs to achieve decompression, followed by fusion to stabilize the treated segment.
Anesthesia & positioning
General anesthesia is administered and you are positioned supine to optimize safety and surgical access.
Anterior approach
A small incision is made on the front/side of the neck, and the cervical spine is carefully approached through natural tissue planes.
Discectomy & decompression
The affected disc is removed and, when needed, bone spurs are addressed to relieve pressure on the nerve roots and/or spinal cord.
Fusion & stabilization
A graft/implant is placed into the disc space and, in many cases, a plate and screws are used to provide stability while fusion develops.
After surgery: recovery & return to activity
Recovery is gradual and individualized. Mobilization (sitting/walking) typically begins early, while higher-demand activities are reintroduced progressively with guidance from your team.
The first weeks
- Pain control with clear instructions and a careful return to light daily activities
- Avoiding heavy lifting and strenuous exercise for a period of time (case-dependent)
- A cervical collar in selected cases, as directed
- Incision care and hygiene/wound-healing guidance
Returning to work and activities
- Often avoiding intense strain for at least ~6 weeks (individualized)
- Return to work commonly within 3–6 weeks, depending on job demands and recovery
- Physical therapy/strengthening may begin at 4–6 weeks when appropriate
- Fusion takes time—often months—to mature and is monitored with scheduled follow-ups
Risks & potential complications
Every surgical procedure carries potential risks. Our goal is maximal safety through careful planning, refined technique, and intraoperative neuromonitoring when indicated.
Examples may include
- Infection
- Bleeding
- Swelling
- Neurologic deficit (e.g., weakness or sensory changes)
- Deep vein thrombosis (DVT) / thromboembolic events
- Anesthesia-related complications
- For ACDF specifically, temporary difficulty swallowing (dysphagia), hoarseness, or the need for additional treatment/reoperation in selected cases
Risk varies based on diagnosis, level(s) treated, anatomy, and overall health—and is always discussed in an individualized manner.
When to contact us urgently
After discharge, contact our team promptly if you experience symptoms that are new, worsening, or concerning.
Contact us if you develop
- Persistent bleeding or drainage from the incision
- Yellow/green discharge or signs of infection
- Fever
- Severe pain not improving with prescribed guidance
- New weakness or numbness
- Neck swelling
- Difficulty breathing
- Worsening swallowing difficulty or inability to tolerate oral intake
Frequently asked questions (FAQ)
Answers to questions we commonly hear before and after Anterior Cervical Discectomy and Fusion (ACDF). Recommendations are always individualized by your care team.
How long does an ACDF take?
How many days will I stay in the hospital?
When can I drive again?
When can I return to work?
Will I need physical therapy?
When will I need follow-up imaging?
Speak with a specialized spine team
If ACDF has been recommended to you—or if you are seeking a second opinion—our team can review your imaging and discuss a safe, individualized treatment plan tailored to your specific condition.