Anterior Cervical Decompression and Fusion Surgery

What Is Anterior Cervical Decompression and Fusion Surgery?

An anterior cervical discectomy and fusion (ACDF) is a surgical procedure performed to treat certain conditions affecting the neck and cervical spine. The goal of the procedure is to relieve pressure on the spinal cord or nerve roots and stabilize the affected area of the spine.

During an ACDF, the surgeon makes an incision in the front of the neck to access the cervical spine. The muscles and tissues are gently moved aside to expose the problem disc or discs. A discectomy is then performed, which involves removing the damaged or herniated disc(s) that may be compressing the spinal cord or nerve roots.

After the disc is removed, the space between the adjacent vertebrae is usually filled with a bone graft. The bone graft promotes fusion, which is the process of joining the two vertebrae together to form a single, solid bone. The graft may be taken from the patient’s own body (autograft) or obtained from a bone bank (allograft). The surgeon then places a titanium metal implant called a cervical plate with screws to provide additional stability during the fusion process.

The fusion process typically takes several months to complete. During this time, the bone graft gradually fuses the vertebrae together, resulting in a solid bone bridge. This fusion helps to stabilize the spine, relieve symptoms, and prevent further degeneration or movement between the vertebrae.

What Is the Success Rate for an Anterior Cervical Decompression and Fusion Surgery?

Patients that undergo anterior cervical decompression and fusion surgery have self-reported success rates between 85%-95% after 10 years of follow-up from the original surgery. This procedure reduces overall pain, weakness, numbness and tingling in your neck, arms, and hands. Patients have reported increased satisfaction following ACDF due to its immediate pain improvement.

Conditions ACDF Treats

ACDF is commonly performed to treat conditions such as herniated discs, degenerative disc disease, spinal stenosis, and cervical fractures. It can help alleviate symptoms such as neck pain, arm pain, weakness, numbness, and tingling caused by compression of the spinal cord or nerve roots in the cervical spine. The procedure is usually considered after conservative treatments, such as medication, physical therapy, or epidural injections, have failed to provide sufficient relief.

Preparation for ACDF

The patient can do the following to better control their surgical success:

Physical and mental health play a significant role in postoperative success. Surgery will take a physical toll on the body, so be sure to eat plenty of nutrients and strengthen muscles through exercise. Quitting habits like smoking and drinking can also increase your chance of success. Additionally, mental health can affect positivity levels and, thus, overall recovery time.

Getting the patient’s home ready before surgery can save a lot of stress and hassle afterward. A neck brace is usually required after surgery and can prevent the patient from doing certain tasks, like reaching up to a cabinet or bending down to feed a pet. Make sure everything is easily accessible, and consider bringing the bed to the home’s main level if it is not there already.

The doctor will sit with the patient and go through any medical history, current medications or health conditions that might interfere with surgery. The doctor may request the patient to stop taking a particular medicine or supplement before ACDF surgery. It is important to comply with these orders to ensure the patient’s safety.

What to Expect From the Surgery

Get a better look at pre-op, surgical and post-op procedures for ACDF below.


  • Before surgery, the entire procedure will be discussed with the patient. The surgeon will walk the patient through everything that will happen during surgery, including the risks. This is all done so that the patient is aware and involved in their care decisions.
  • The patient will once again be asked if any allergies or medical conditions are present that could affect the surgical outcomes. Once the patient is cleared, they will head to the operating room.

During Surgery

  • The patient will be under general anesthesia throughout the entirety of the surgery. ACDF surgery involves two parts — the anterior cervical discectomy and the fusion.
  • The anterior cervical discectomy — or decompression — begins with a single incision in the lower front of the neck. The surgeon will carefully navigate the neck muscles to expose the front of the cervical spine. The esophagus and trachea are moved away from the midline for a better look at the affected area. Retractors are then inserted to protect the surrounding tissue of the neck.
  • Removing the affected disc completes the discectomy, and the fusion step immediately begins. Here, the surgeon will stabilize the surgical segment by inserting a Polyetheretherketone (PEEK) cage with a bone graft. A titanium plate and screws will then be used as structural support to hold the PEEK cage and bone graft in place as it fuses over time.


  • Following the procedure, the patient will be taken back to a hospital room and will stay for one to two days to remain comfortable and start working on daily tasks. Doctors will monitor the incision. Patients will wear a cervical neck brace to discourage turning and bending of the neck. The goal is for the patient to begin walking on the day of surgery to ensure there are no complications. To be discharged, the patient must be able to eat, drink and urinate on their own and only require oral pain medications.
  • The patient may initially have some trouble swallowing or have a sore throat due to the manipulation of the esophagus during surgery. This can resolve within a few days. If the feeling persists, call the doctor.

Potential Risks with ACDF

ACDF is generally a safe surgery. However, all surgical procedures can have potential risks.

Some complications that can occur with ACDF include:

  • Damage to the laryngeal nerve, causing hoarseness or swallowing difficulty
  • Infection of the incision
  • Damage to the carotid or vertebral artery, resulting in bleeding or stroke
  • Mechanical complications with the bone graft plate, screws or rods
  • Heaviness or weakness in the upper arms or deltoid muscles 

How Long Does It Take to Recover From ACDF?

There can be a wide variation of recovery times from patient to patient. Recovery can be determined by their job, potential complications from surgery and other individual factors. Consider the following answers to these frequently asked questions.

Yes, a neck brace is usually required following ACDF surgery. The patient may wear this from four to six weeks and should keep it on at all times until told otherwise, except when sleeping or showering.

Complete recovery times from ACDF can differ. It can take up to one year for the bone graft to be completely fused to the surrounding vertebrae.

It is recommended that patients wait two days before showering after surgery. Be careful when rinsing the incision with soap and water — do not scrub. Following the shower, gently pat the incision to dry it.

Baths and other types of submersion — like swimming pools or hot tubs — are not permitted until around two weeks after the surgery or after the incision has completely healed.

Exercising or any strenuous activity should wait until around six weeks following ACDF surgery. This time frame will likely be when physical therapy also begins, teaching the patient to move safely and return to regular activities.

Dr Abrams explaining spine x-ray Dr. Abrams laughing

Contact DISC Today

For more information on anterior cervical decompression and fusion surgery, schedule an appointment with Desert Institute for Spine Care today. We’re eager to help you get your life back on track.


Our spine health blog features up-to-date spine education and expert spine tips from our spine specialists here at DISC.

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