Cervical Surgery Animation

Anterior cervical discectomy and fusion (ACDF)

An anterior cervical discectomy and fusion (ACDF) is one of the most common cervical (neck) spine surgeries. This type of spine surgery may be recommended to treat a herniated disc in the neck. This video animation explains the anatomy of the neck and demonstrates how an ACDF surgical procedure is performed.

Purpose of Cervical Intervertebral Discs

In between each of the 7 vertebrae in your cervical spine (your neck), is an intervertebral disc. Each disc separates two vertebral bodies and creates open passageways through which nerve roots to exit the spine. The discs also have shock absorbing characteristics that help to cushion and distribute loads and forces in the cervical spinal column.

Herniated Discs and Neck Pain

Sometimes an intervertebral disc in the neck herniates. A herniated disc occurs when the gel-like interior of the disc (the nucleus pulposus) pushes beyond the protective outer layer that’s made of a fibrous type of cartilage called the annulus fibrosus.

There are many different causes for cervical disc herniation, such as age-related spinal wear and tear, trauma or injury (eg, whiplash). Regardless of what causes the disc herniation, it is usually quite painful. Part of the disc’s nucleus pulposus can press on nearby spinal nerves and/or the spinal cord; this is called nerve or spinal cord compression (eg, neural compression). Neural compression causes pain and sometimes other symptoms, such as tingling sensations and numbness.
Illustration of an intervertebral discA herniated disc in the cervical spine (neck) can cause nerve compression leading to neck pain. Photo Source: 123RF.com.It's also possible for your intervertebral discs to lose height, become thinner. This is usually an effect of degenerative changes related to growing older and spinal wear and tear. As a disc thins the space between the two vertebral bodies decreases and can lessen the size of the nerve passageways, which may lead to nerve compression, pain and other types of symptoms.

When ACDF May Be Recommended

The purpose of anterior cervical discectomy and fusion is to remove the damaged disc, relieve nerve compression, restore lost height between the vertebral bodies and stabilize the cervical spine. ACDF is a common type of neck surgery your doctor may recommend to relieve pain and other symptoms.

ACDF may be performed as a traditional open procedure or minimally invasively, if you are a candidate. The surgery basically involves removing (discectomy) the damaged disc and filling the empty space with interbody spacers. The fusion part of the surgery involves bone graft, which is packed into and around the interbody spacers. A plate is affixed with screws to further stabilize the cervical spine.

Anterior Cervical Discectomy and Fusion Procedure

An anterior procedure is performed from the front of the spine. In an ACDF, a small incision is made at the front or side of the neck. Most surgeons make the incision in a natural neck skin crease. This helps minimize the appearance of a scar. The surgeon retracts (moves to the sides) the muscles and other soft tissues to reach the specific level of the cervical spine.

By means of a discectomy procedure, the surgeon removes the damaged disc and as needed, removes soft tissues pressing on nearby spinal nerves. Interbody spacers or small devices are implanted into the empty disc space. These devices separate the intervertebral bodies and restore lost disc height necessary to provide sufficient room for nearby nerve roots.

Bone graft, either your own (ie, autograft) or another type is packed into and around the interbody spacers. Bone graft can help stimulate new bone growth helping the fusion to heal. A cervical plate is affixed using bone screws to help stabilize the cervical spine.

Next, the soft tissues (eg, muscles) are gently allowed to move back into position and your incision is closed. Some patients are instructed to wear a supportive cervical brace for following surgery to help immobilize the spine while the fusion heals.

Updated on: 05/27/19