Anterior Cervical Discectomy with Fusion (ACDF) for Cervical Spinal Stenosis

Not all operations for cervical spinal stenosis are conducted from the posterior spine as the presence of disc herniation and compression is often more likely in the front of the spinal column than the back. In such cases the surgery may take an anterior approach such as in an anterior cervical discectomy with fusion. This operation involves the surgeon making a small incision in the front of the neck and then gently easing aside the muscles, ligaments, and nerves to reach the spinal column. The problematic disc, or the herniated disc material, will be removed and the surgeon may position a bone graft between the vertebrae at that level to maintain the height and curvature of the cervical spine. Where only a small amount of the disc material is removed, this fusion may not be necessary, but spinal slippage, and further stenosis, can occur if the disc continues to degenerate.

If a number of discs in the cervical spine are degenerative then the surgeon is much more likely to excise these problem discs and perform a fusion procedure to restore spinal stability. The use of artificial discs is increasing, and these have the advantage of maintaining the relative flexibility of the neck and reducing the risk of adjacent segment syndrome. For patients with evidence of stenosis due to disc herniation and osteophyte growth the surgeon may need both an anterior and posterior approach in order to reach all of the material causing both nerve and spinal cord compression. An anterior cervical discectomy may be followed by a foraminotomy, for instance, where bone spurs in the posterior portion of the spine are removed to decompress the nerves. Fusion from the front of the spine is usually indicated in order to maintain the natural lordotic curve of the cervical spine.

Alternative Treatment Options for Cervical Spinal Stenosis –> Spinal Fusion