Discectomy Procedures
Anterior Cervical Discectomy Fusion (ACDF)
Relieving Neck and Arm Pain with a Reliable, Proven Procedure
Anterior Cervical Discectomy and Fusion (ACDF) is one of the most commonly performed spine surgeries worldwide. It relieves pressure on nerves or the spinal cord in the neck by removing a damaged disc and stabilizing the spine with a bone graft and plate. At Desert Spine and Pain, neurosurgeon Dr. David L. Greenwald, M.D., FAANS, FACS has extensive experience with ACDF, performing it with advanced precision and minimally invasive techniques. Patients often experience dramatic relief of arm pain, numbness, and weakness within days of surgery.
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What Is ACDF?
In simple terms: We make a small incision in the front of the neck, remove the damaged disc, and fuse the two bones together with a graft and small plate.
Scientifically: ACDF involves anterior cervical exposure, microsurgical discectomy with decompression of neural elements, interbody graft placement, and anterior cervical plate fixation. Arthrodesis occurs as bone grows across the disc space.
Conditions Treated
Herniated cervical disc
Cervical radiculopathy (arm pain, numbness, weakness)
Cervical myelopathy (spinal cord compression)
Degenerative disc disease in the neck
Cervical instability or deformity
Cases unresponsive to conservative care (PT, medications, injections)
The ACDF Procedure: Step by Step
Plain-English Overview
Anesthesia & positioning: You’re asleep under general anesthesia, lying on your back.
Small incision: A 1–2 inch incision is made in the front of the neck.
Disc removal: The damaged disc is removed, along with bone spurs pressing on nerves or spinal cord.
Nerve decompression: The spinal cord and nerves are freed of compression.
Bone graft placement: A graft or cage is inserted into the disc space to maintain height.
Plate fixation: A small titanium plate and screws secure the graft.
Closure: The incision is closed; most patients walk the same day.
Surgeon-Level Detail
Exposure: Smith-Robinson anterior cervical approach; dissection between sternocleidomastoid and strap muscles to prevertebral fascia.
Localization: Fluoroscopy confirms level; longus colli elevated laterally.
Discectomy: Microsurgical annulotomy and nucleus removal; posterior longitudinal ligament resected if compressive.
Decompression: Osteophytectomy with Kerrisons/drill to free thecal sac and roots.
Graft/cage: PEEK/titanium cage or structural allograft packed with autograft/allograft.
Plating: Anterior cervical plate and variable-angle screws fixate construct.
Hemostasis/closure: Irrigation, drain optional, layered closure.
Benefits
High success rate for relieving arm pain and radiculopathy
Small incision, usually cosmetically hidden in a neck crease
Restores disc height and alignment
Immediate stability with plate fixation
One of the most reliable spinal surgeries with decades of proven outcomes
Risks & Limitations
Difficulty swallowing (dysphagia), usually temporary
Hoarseness from recurrent laryngeal nerve irritation (rare, often resolves)
Non-union (pseudoarthrosis) in some cases, especially smokers
Hardware issues (loosening, breakage—rare)
Adjacent segment disease (wear at levels above/below fusion) over time
Recovery Timeline
Day 0: Up and walking same day; many patients go home within 24 hours
Weeks 1–2: Mild throat soreness, temporary swallowing difficulty
Weeks 2–6: Return to desk work and light activities
6–12 weeks: Begin structured physical therapy; fusion begins consolidating
3–6 months: Most patients return to full activity
6–12 months: Fusion confirmed on X-rays; long-term stability achieved
Why Choose Desert Spine and Pain?
Expert neurosurgeon: Dr. Greenwald has extensive experience with ACDF and complex cervical spine surgery
Minimally invasive focus: Small incisions, rapid recovery, and reduced complications
Patient-first approach: Conservative care first; surgery only when it’s the best option
Comprehensive care: From diagnosis through recovery, everything is managed in one place
Frequently Asked Questions
How successful is ACDF?
ACDF has a very high success rate for relieving arm pain and neurologic symptoms.
Will I lose neck mobility?
One fused level has minimal effect on motion. Multi-level fusions may reduce flexibility more noticeably.
How long will I need a brace?
Sometimes a cervical collar is used for comfort during the first weeks. Many patients don’t need one long-term.
Can the problem come back?
Not at the fused level, but adjacent levels can degenerate over time (adjacent segment disease).
How does Desert Spine and Pain perform ACDF differently?
We use microsurgical precision, advanced implants, and compassionate care to ensure the safest, most effective outcome possible.
Dr. David L. Greenwald, MD
Neuro-Spine Surgeon
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If you’re suffering from neck pain, arm weakness, or numbness caused by cervical disc or nerve compression, Anterior Cervical Discectomy and Fusion (ACDF) may be the right treatment for you. Dr. Greenwald and his caring team will perform a detailed evaluation, explain your options, and create a treatment plan tailored to your specific needs. Every step you take toward expert spine care brings you closer to comfort, strength, and restored mobility. Schedule your consultation today and learn how Dr. Greenwald’s surgical expertise in ACDF can help you live pain-free and confident once again.
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Over 30 Years Experience in Orthopedic & Neuro Spine Surgeries.
Dr. David L. Greenwald, M.D., F.A.C.S.
Neurosurgeon | Spine Surgeon | Regenerative Medicine
Dr. David L. Greenwald, MD, FACS, is a board-certified spine surgeon specializing in Anterior Cervical Discectomy and Fusion (ACDF), one of the most effective procedures for relieving neck and arm pain caused by herniated discs, spinal stenosis, or degenerative disc disease. In this minimally invasive procedure, Dr. Greenwald removes the damaged disc through a small incision in the front of the neck to decompress the spinal cord and nerves, then stabilizes the spine using a bone graft and specialized plate system. This fusion promotes long-term stability while alleviating nerve compression and restoring alignment. Known for his precision and compassionate care, Dr. Greenwald has helped countless patients throughout South Florida find lasting relief and improved quality of life through advanced cervical spine surgery.
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