Cervical Procedures

Anterior Cervical Discectomy and Fusion (ACDF)

  • ACDF is most commonly recommended for patients with cervical disc herniation, spinal stenosis, or degenerative disc disease that compresses the spinal cord or nerve roots. Symptoms may include neck pain, arm pain, numbness, tingling, or weakness that has not improved with physical therapy, medications, or injections. It may also be indicated in cases of spinal instability, deformity, or after trauma.

  • ACDF is a surgical procedure performed through a small incision in the front of the neck. The damaged disc is removed to relieve pressure on the spinal cord and nerves. Once the disc is removed, the space is filled with a spacer or graft material, and a small plate and screws are used to stabilize the segment while the bones fuse over time. The goal is to relieve symptoms and restore stability and alignment to the cervical spine.

  • As with any surgery, there are potential risks. These include:

    • Infection

    • Bleeding or hematoma

    • Injury to the esophagus, trachea, or nearby blood vessels

    • Hoarseness or difficulty swallowing (typically temporary)

    • Nonunion (failure of the bones to fuse)

    • Adjacent segment disease (increased stress on nearby spinal levels over time)

    • Persistent or recurrent symptoms

    Your surgeon will discuss your individual risk profile and answer any questions before surgery.

  • Most patients go home the same day or after an overnight stay. Mild discomfort in the throat and neck is common initially. A cervical collar may be used for comfort. You’ll be encouraged to walk shortly after surgery, and most patients resume light activities within a few days. Lifting, driving, and strenuous activity should be avoided until cleared by your surgeon—typically 4 to 6 weeks post-op. A follow-up plan will include X-rays to monitor healing and, if needed, physical therapy to rebuild strength and flexibility.

Posterior Cervical Decompression and Fusion

  • Posterior cervical laminectomy and fusion is typically recommended for patients with multi-level cervical spinal stenosis causing spinal cord compression (myelopathy), especially when the compression spans several levels or lies behind the spinal cord. It may also be indicated in cases of instability, trauma, tumors, or failed prior anterior surgery. Common symptoms include hand clumsiness, gait imbalance, weakness, numbness, and in some cases, bowel or bladder dysfunction.

  • Through an incision along the back of the neck, the surgeon removes portions of bone (lamina) and thickened ligaments that are compressing the spinal cord. This relieves pressure on the nerves and allows for decompression across multiple levels. To restore stability, titanium screws and rods are placed in the spine, and bone graft is used to promote fusion across the operated segments. The procedure preserves spinal alignment and prevents further collapse or deformity.

  • As with any major spine surgery, there are risks, which may include:

    • Infection

    • Bleeding or hematoma

    • Nerve injury or spinal cord injury

    • C5 nerve root palsy (temporary or permanent shoulder/arm weakness)

    • Nonunion (failure of the bones to fuse)

    • Implant-related complications

    • Wound healing problems, especially in patients with prior radiation or poor tissue quality

    • Persistent or recurrent symptoms

  • Most patients stay in the hospital for 1–3 days after surgery. You may experience muscle soreness and stiffness in the neck and shoulders, which gradually improves. A soft collar may be used for comfort. Light activity and walking are encouraged early on, but lifting, driving, and strenuous activity should be avoided until cleared by your surgeon—typically within 4 to 8 weeks. Physical therapy may be recommended to restore strength and mobility once healing is underway. Long-term follow-up with imaging helps confirm fusion and monitor alignment.