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Understanding Spine Surgery: ACDF vs. Microdiscectomy

Why Consider Neuro Injury Care Institute for Your Surgery or Treatment

If you’d like to enjoy life with less neck pain, start by calling the top spine surgeons of Neurodiagnostics Medical, P.C., to learn about ACDF surgery!

A surprising number of adults experience neck pain. In fact, data from the National Library of Medicine indicates that one in three adults experiences neck pain at least once a year. In many cases, the pain is temporary and goes away on its own, but there are times when it is ongoing and requires a look from a top neurologist in NYC.

If your neck pain comes from a damaged disc, and your nonsurgical treatments like physical therapy or medicine haven’t provided relief, the best option may be surgical treatment. For example, removing some or all of a herniated or degenerated disc in the cervical spine can instantly relieve pressure on nearby nerves, reducing your pain and feelings of weakness. Surgery can also restore neck stability.

Data gleaned from Stryker, a medical technology provider, revealed that about 200,000 people undergo cervical spinal surgery every year in the country. The majority of those surgeries are either microdiscectomy or anterior cervical discectomy and fusion, more commonly known as ACDF surgery. 

Which procedure is best for you? Your neurologist will look at the extent of the disc damage and your symptoms before offering a recommendation. Both are effective for reducing pain, so to help you weigh these options, we look at the details of both surgeries below.

Neurology’s Take on The Types and Causes of Neck Pain

Neck pain is often nothing to worry about. Did you sleep awkwardly or look down at your phone for too long? You might have some temporary stiffness and soreness, then. 

However, ongoing neck pain can be a reason for concern, especially with the two primary types of neck pain:

  • Axial pain hovers around the spine in the neck and affects the shoulders somewhat.
  • Radial pain spreads along the nerves into your head or along your arms. 

You likely already know that whiplash from a vehicle accident is one of the most common causes of neck pain in the United States. A herniated cervical disc also causes arm pain that’s worse than neck pain, as well as weakness in the arms and hands (it compresses nearby nerves). Some other potential issues arise from the following:

  • Herniated (bulging) discs
  • Degenerative conditions (wear and tear on the discs and spinal bones) 
  • Weak or overused muscles 

Often, treating these various conditions can help alleviate the pain. It might also restore quality of life overnight with the right approach.

An Overview of ACDF Surgery 

An Overview of ACDF Surgery 

Anterior cervical discectomy and fusion procedures are the most common neck surgeries, with about 137,000 people undergoing this treatment annually. Neuroscience Journal reported that 93% of patients confirm a good or excellent outcome in terms of pain relief and overall satisfaction after ACDF.

How does ACDF surgery work?

  • Spine surgeons make an incision in the front of the neck to access the cervical spine. 
  • They remove the damaged disc—the flexible, spongy cushion between the vertebrae.
  • They then fuse the two vertebrae on either side with a graft.

The graft essentially serves as a bridge between the two vertebrae, filling the space so that your bones don’t collapse onto each other. 

When to Consider Anterior Cervical Discectomy and Fusion Surgery 

Spine surgeons typically recommend ACDF after conservative treatments fail. Surgically removing a disc alleviates the pressure and discomfort from the following:

  • A herniated or bulging disc. When there’s damage to the disc’s exterior, the gel-like substance inside it bulges or leaks. 
  • Degenerative disc disease. As we age, spinal discs dry out and shrink, which can cause vertebrae to rub together and pinch nerves.
  • Cervical stenosis. Narrowing of the spinal column due to something like a bulging disc, thickened ligaments, or enlarged bones can cause pain and weakness in your extremities. It puts pressure on the spinal nerves.

Your Expected Recovery After ACDF

Typically, this surgery takes about one to three hours, and most people return home the same day. If you have a fusion with a bone graft, the surgeon will remove some bone from your hip during the procedure.

Recovery should be four to six weeks, but the total fusion takes a few months more. Once you heal, the surgeon will recommend physical therapy so that you can regain strength and range of motion in your neck. 

Overall, ACDF is most effective if disc damage in your neck has caused some arm pain. For example, research in the journal Neurosurgery showed that 93% to 100% of patients who underwent this procedure experienced total relief from their arm pain. Around 73% to 83% also saw a reduction in neck pain.

An Overview of the Microdiscectomy Procedure 

An Overview of the Microdiscectomy Procedure 

What is a microdiscectomy? This minimally invasive surgery removes the bone fragments or a portion of the herniated disc affecting your nearby nerves. Like ACDF surgery, surgeons only suggest microdiscectomies when other treatments don’t provide relief.

To perform a microdiscectomy, the surgeon does the following:

  • A small incision in the back of the neck
  • Remove the affected bone or tissue causing the compression or irritation
  • Do not remove the entire disc (fusion isn’t necessary).

When to Consider Microdisectomies

As a less invasive procedure, you can usually expect a slightly faster recovery time than with ACDF. However, because it only removes a portion of the disc, there’s a risk the bulge could return. Research indicates that the risk for recurrent herniation is up to 4.4%.

Also, because most surgeons prefer to access the cervical spine via the front of the neck rather than the back, microdiscectomy recommendations usually extend to treating herniated discs in the lower back. They’re also a far more common treatment option for sciatica than a herniated disc in the neck.

Recovering From a Microdiscectomy

Like ACDF, most microdiscectomies are outpatient procedures and take two hours from start to finish. After discharge, expect to rest for about two weeks before beginning physical therapy to strengthen your core muscles and increase your joint flexibility. 

The total recovery takes about six weeks. You may need to continue an exercise program to support your back and spine for several months post-surgery.

Overall, most people who undergo a microdiscectomy report a positive outcome. For example, the International Journal of Spine Surgery looked at patients’ social media posts after surgery, and about 98% of the comments were positive.

Don’t Wait To Get Treatment for Neck Pain From a Top Neurologist in NYC!

Living with any type of neck or back pain can be debilitating, affecting every aspect of your life. You do not have to suffer in silence or give up—just make an appointment with a top neurologist in NYC to get to the bottom of your pain! 

With professionals like Neurodiagnostics Medical, P.C., you can explore a variety of treatment options to find the one that helps you live as pain-free as possible. Effective pain management options like ACDF address the underlying causes of your pain, not just the symptoms.

Why not start by making an appointment with Neurodiagnostics Medical, P.C.? Call (347) 602- 9530 for everything from lower back pain due to accidents to work-related injuries and sciatica. Our doctors accept most insurance plans, including workers’ compensation, no-fault, and PIP (personal injury protection), and same-day appointments may be available.

Our team provides an array of treatments to help with your pain and discomfort, as well as insight about when to get surgery from a lower back pain specialist

Frequently Asked Questions About Spine Surgery 

Your spinal surgeon provides detailed information about your procedure. Still, here are common questions patients ask about these cervical spine surgery and recovery experiences.

How Long Does It Take to Recover From Cervical Spine Surgery?

Typically, people recover from cervical spine surgery and return to work after four to six weeks. It can take several months to return to regular activity. Stiffness and soreness are common in the weeks following the surgery but diminish within a few weeks.

Can You Turn Your Head After ACDF Surgery?

There is some limitation in being able to turn your head after ACDF because the procedure fuses your two spinal vertebrae to improve your spinal stability. It can cause some permanent loss of flexibility in the neck, but you will still be able to turn your head left to right to read. You likely won’t be able to move your head forward and backward as easily or as far.

Will I Have Any Permanent Activity Restrictions After Neck Surgery? 

No, you shouldn’t experience permanent activity restrictions after neck surgery like ACDF. Quite the opposite, many people who undergo surgery on the cervical spine feel free of pain and instability that previously kept them from enjoying activities. After recovery, most people can do everything they did before surgery but may need some precautions when lifting heavy objects or engaging in extreme sports like mountain biking.

How Do You Sleep After ACDF or a Microdiscectomy?

For some time after ACDF or microdiscectomy, you might have difficulty finding a comfortable sleeping position. However, you can sleep in any position that’s comfortable. Many people find a recliner helpful

About The Author

Picture of Ashwin Malhotra, M.D.

Ashwin Malhotra, M.D.

Ashwin Malhotra, M.D. is a highly respected neurologist based in New York City. With over 20 years of experience in the field of neurology, he has earned a reputation as a leading expert in the diagnosis and treatment of neurological disorders and traumatic brain injuries. In addition to his clinical work, Dr. Malhotra is also a dedicated educator and researcher. He has published numerous articles in peer-reviewed medical journals and has presented his research at national and international conferences.