Post-Operative Management for Anterior Cervical Discectomy and Fusion (ACDF)

Radiographic Follow-up

The American College of Radiology recommends using CT as the most sensitive and specific modality to assess spinal fusion status, which altered the treatment plan in 39% of patients with persistent symptoms and in 60% of patients with persistent symptoms plus abnormal radiographs or MRI 1
The American College of Radiology also notes that MRI is the most sensitive imaging test for detecting soft-tissue abnormalities but may be limited by metal artifact from hardware 1
Adjacent segment degeneration is a potential long-term complication that may require monitoring, according to the American College of Radiology 1

The American Association of Neurological Surgeons reports that ACDF has demonstrated good to excellent outcomes in approximately 90% of properly selected patients with cervical radiculopathy 2
Fusion rates with anterior plating are significantly higher (94% overall) compared to ACDF without plating (88%), with the difference being more pronounced in 2-level procedures (91% vs 72%), as reported by the American Association of Neurological Surgeons 3

The American Association of Neurological Surgeons found that return to work and resumption of driving occur faster with plated ACDF compared to non-plated ACDF (p < 0.05) 3
Most patients can expect significant improvements in physical function, social function, physical role function, fatigue, and bodily pain following ACDF, according to the American Association of Neurological Surgeons 2

The American Association of Neurological Surgeons recommends that if pseudarthrosis occurs (failure of fusion), posterior revision approaches have higher success rates (94-100%) compared to anterior revision approaches (45-88%) 4

Lifting more than 10 kg (approximately 22 pounds) after ACDF surgery can compromise the fusion construct during the critical healing period and increase the risk of pseudarthrosis, as reported by the Journal of Neurosurgery 5, 6

Return to driving occurs faster with plated ACDF compared to non-plated procedures, with a statistically significant difference (p < 0.05), according to the Journal of Neurosurgery 6, 7

Return to work occurs faster with plated ACDF compared to non-plated procedures, with a statistically significant difference (p < 0.05), as reported by the Journal of Neurosurgery 6, 7