Anterior Cervical Discectomy with Fusion (ACDF)

Anterior cervical discectomy with fusion, or ACDF, is one of two common surgery options for people suffering from cervical spondylotic myelopathy, or CSM. CSM is one of the most common causes of spinal cord dysfunction in adults aged 55 or older, and ACDF may relieve pain and restore function for people whose symptoms do not respond to nonsurgical methods.

Other conditions, like injury, rheumatoid arthritis, and cervical radiculopathy (pinched nerve), may also cause spinal compression that may be alleviated through ACDF or other spine surgeries.

Cervical Spondylotic Myelopathy

Cervical spondylotic myelopathy (CSM) is a degenerative condition of the neck that occurs as a normal part of aging. It compresses the spinal cord due to wear and tear on one or more of the seven vertebrae that comprise the neck, or cervical spine. As the discs, ligaments, connective tissue, and vertebra become damaged, they place pressure on the spinal cord.

Because the spinal cord compression in CSM occurs so high along the spinal column, symptoms of the degenerative condition may occur in nearly any portion of the body. Commonly, symptoms of cervical spondylotic myelopathy include the following:

• weakness or numbness of the hands

• weakness or numbness of the arms

• problems with balance

• loss of coordination

• neck pain

Typically, the first line of defense in fighting the symptoms of CSM is to use non-invasive, non-surgical methods. Nonsurgical treatment may include bracing through a soft cervical collar, anti-inflammatory drugs, pain medications, steroid treatment (oral corticosteroids or epidural injections), and physical therapy.

However, if a person’s pain and dysfunction are not alleviated through noninvasive treatments, it may be time to consider surgical methods like ACDF for the treatment of CSM.

Anterior Cervical Discectomy with Fusion

The American Academy of Orthopaedic Surgeons (AAOS) reports that anterior cervical discectomy and fusion is the most common surgical treatment of cervical radiculopathy, or pinched nerves, and it may also be used in treating CSM.

In ACDF, “anterior” refers to the direction from which the surgeon approaches the damaged portion of the spine. In an anterior approach, the surgeon works from the front of the neck to remove damaged discs (discectomy) that are causing spinal compression and associated symptoms.

Once the damaged disc or discs are removed, the neck is stabilized by fusing the vertebrae together via bone graft. This provides support for the neck and prevents the affected area from collapsing around the removed disc and again compressing the spine.

The goals of anterior cervical discectomy and fusion are to create necessary space around the spinal nerves to avoid compression, realign the spine, and limit movement of degenerated segments, which could cause additional injury.

Possible ACDF Candidates

According to the American Academy of Orthopaedic Surgeons, patients exhibiting the following symptoms may require surgical treatment, such as ACDF:

• weakness or numbness of the hands, arms, or legs

• difficulty with fine motor skills

• imbalance

• gait changes

• severe and debilitating pain

Anterior cervical discectomy with fusion is only one surgical treatment option available to people suffering from cervical spondylotic myelopathy and other neck problems. Contact our team of spine specialists today to find out if ACDF is the right treatment choice for you.