Overview of Procedure
Typically, an incision is made on either the right or left side of the front of the neck, exposing the front of the spine. Working from front to back, the entire disc between the vertebrae is removed, including any material or bone spurs compressing the spinal cord or nerves. This creates a gap between the vertebrae where the disc was.
In an ACDF, a “cage” resembling a thick washer with a hollow center is inserted. Donated bone graft is placed inside the cage, which is then inserted between the vertebrae and often reinforced with a small plate and screws. Fusion of 1, 2, 3, or 4 discs can be achieved in this manner, allowing the bones to grow together as a solid unit.
Recovery
The recovery process varies based on factors such as whether a fusion is performed, and the number of discs removed during surgery. For a 1 or 2 level ACDF, patients can go home the same day. A drain is usually placed in the neck, which can be removed at the office the day after surgery. Dressings can be removed, and showers resumed on the second day post-surgery.
If bone quality is good in a 1 or 2 level ACDF, a neck collar may be provided for comfort, though it doesn’t need to be worn continuously. Driving can be resumed once narcotic pain medications are discontinued. In the case of a fusion, depending on the number of levels addressed, it may take 8 to 12 weeks to resume full activity.