Cervical spineMinimally invasive surgery

Anterior cervical discectomy and fusion (ACDF)

Anterior cervical discectomy and fusion (ACDF) is a surgical procedure designed to relieve neck pain and neurological symptoms caused by a cervical disc herniation or stenosis compressing a nerve root or the spinal cord. Many patients look to this option after persistent, limiting pain, weakness or functional loss that does not improve with physiotherapy, medication or injections. This guide provides realistic, supportive information through each phase so you can make a calm, informed decision.

Spine neurosurgeon in Alicante and Benidorm

More than 20 years of experience in Neurosurgery (since 2003)

Vithas Medimar Hospital Alicante and Hospital Clínica Benidorm

Medical illustration of anterior cervical discectomy with fusion for segment stabilization.

What is anterior cervical discectomy and fusion (ACDF)?

ACDF is a surgical procedure in which the damaged cervical disc is removed through an anterior approach to the neck. After disc removal, an interbody graft or cage is placed, often fixed with a plate and screws, to stabilise the spine and promote fusion of the treated segment. Compared to other cervical procedures such as cervical microdiscectomy or disc arthroplasty, ACDF not only decompresses the nerve root or spinal cord but also stabilises the treated level, making it especially useful in advanced degeneration or instability. To discuss your specific case, you can request an assessment with Dr. Ben Ghezala.

Symptoms and warning signs

Patients who may benefit from ACDF typically report:

Neck pain radiating to the shoulder, arm or hand

Tingling, numbness or weakness in the upper limbs

Pain that worsens with head movement or prolonged postures

Difficulty performing fine motor tasks or lifting objects

Warning signs: sudden loss of strength, gait instability, bowel or bladder changes or abrupt worsening of pain

When is this procedure indicated?

Cervical disc herniation or foraminal stenosis confirmed by MRI or CT

Persistent symptoms despite physiotherapy, medication or injections

Neurological progression such as weakness, clumsiness or gait disturbances

Disabling pain affecting daily life or work

Segmental instability or significant degeneration where fusion is advisable for stability

How is the procedure performed?

1.Preoperative preparation

Includes clinical assessment, imaging review and addressing patient concerns. Fasting instructions, medication adjustments and tailored preoperative recommendations are provided.

2.During the procedure

ACDF is performed through an anterior approach. The damaged disc is removed, the nerve root or spinal cord is decompressed and an interbody graft or cage is placed. A plate with screws is then fixed to stabilise the segment and promote bony fusion.

3.Immediate postoperative period

After surgery, patients spend a short time in recovery before returning to their room. Pain control is monitored and gentle mobilisation begins. Hospital stay is typically 24–48 hours depending on clinical progress.

Recovery after anterior cervical discectomy and fusion (ACDF)

Recovery is gradual. Light daily activity is usually possible within a few days, and office work is often resumed in 2–4 weeks. Physical jobs require additional time. Fusion develops over several months, so avoiding heavy strain early on is important. Rehabilitation, ergonomic habits and medical follow-up shape the outcome. Fever, severe pain or new neurological symptoms warrant prompt medical review.

Risks and possible complications

General surgical risks include infection, bleeding, anaesthesia-related issues and thrombosis. Specific risks of ACDF include nerve root injury, oesophageal or tracheal injury (uncommon), temporary swallowing difficulty, non-union (pseudarthrosis) or accelerated degeneration of adjacent levels. These risks are assessed individually for each patient.

Frequently asked questions

ACDF typically lasts between 60 and 120 minutes, depending on the number of levels treated. A short recovery period follows before returning to the hospital room.

There is no pain during surgery because it is performed under general anaesthesia. After the operation, mild neck discomfort or temporary swallowing difficulty may appear but is usually well managed with medication.

Most patients return to office work within 2–4 weeks. Jobs involving physical effort require a longer recovery period.

Light activities can be resumed early under medical guidance, while impact sports or heavy lifting are reintroduced gradually once fusion is progressing, typically after several weeks or months depending on recovery and specialist advice.

Recurrence at the operated level is uncommon because the disc is removed and the segment fused. However, other levels may degenerate over time.

ACDF decompresses and stabilises the cervical spine simultaneously. Compared to non-fusion techniques, it offers additional stability in cases of severe degeneration, though it slightly reduces motion at the treated level.

Do these symptoms sound familiar?

If you recognise yourself in some of these symptoms and your pain is starting to limit your daily life, we can review your case in a personalised consultation. Dr. Ben Ghezala will assess your clinical history and imaging studies to help you decide the best treatment option for you.

Request a consultation with Dr. Ben Ghezala