ACDF Surgery in Dubai (Anterior Cervical Discectomy and Fusion)
Who you'll see
Dr Sherief Elsayed
Consultant Spinal Surgeon, FRCS (Tr & Orth), UK-trained
Anterior Cervical Discectomy and Fusion (ACDF) surgery treats a herniated or degenerated disc in the neck region through an anterior incision (front of the neck). ACDF surgery aims to relieve pressure on the spinal cord or nerve roots, which can cause permanent damage if left untreated. Dr Sherief Elsayed, UK-trained Consultant Spinal Surgeon, FRCS (Tr & Orth), performs ACDF in Dubai and also offers cervical disc replacement, so both options can be discussed at one appointment.
What are the symptoms of a patient who needs ACDF surgery?
ACDF surgery is recommended for patients whose diagnostic tests show a herniated or degenerative disc in the cervical region and whose symptoms don’t improve with medication and physical therapy. Given below are some other symptoms of a patient who needs ACDF surgery:
- Loss of sensation in hands
- Arm and neck pain
- Pain in shoulder
- Difficulty using hands
- Difficulties with balance,
- Loss of bladder or bowel control
Diagnosis
After studying the patient’s general health and medical history, the following tests are performed for diagnostic purposes;
Physical examination of the neck
This involves inspecting the patient’s neck by the doctor for any abnormalities. In addition, various tests and observations are carried out to better understand the neck’s posture, range of motions, reflexes, muscle strength, and sensations felt in the legs and arms.
Imaging studies
Given below are some imaging tests that are done to narrow down the cause of neck pain;
X-ray: X-rays use electromagnetic waves to produce images of dense structures. They can reveal the vertebral openings and the general bony structure.
MRI (Magnetic Resonance Imaging)– These use magnetic fields to detect nerve root compression / to assess the health of the cervical discs and the spinal cord.
CT (Computerised Tomography) Scan: These scans generate more detailed pictures of the cervical spine to determine if you have developed bone spurs near the foramen.
Nerve conduction studies (NCS) / Electromyography (EMG): EMG measures the electrical impulses of the muscles at rest and during contractions. EMG studies are often performed along with nerve conduction studies to determine if the nerve is functioning properly.
How is ACDF surgery performed?
The step-by-step procedure for Anterior cervical Discectomy and fusion treatment in Dubai is as follows:
Step 1: Making the incision
After the patient is administered general anaesthesia, a small incision is made to reach the damaged disc from the front (anterior) of the spine through the throat area by moving the neck muscles, trachea, and oesophagus aside.
Step 2: Locating the damaged disc
Next, the surgeon inserts a thin needle into the spine to locate the impacted disc. After the disc is located, a retractor spreads the vertebrae above and below it.
Step 3: Removing the disc
In the third step, the surgeon makes an incision in the disc’s outer wall and removes it using small grasping tools.
Step 4: Decompressing nerves
If any bone spurs are pressing against the patient’s nerve root, they are removed. Afterwards, the surgeon opens the spinal canal to allow the nerves some extra space.
Step 5: Preparing a bone graft fusion
Next, an open disc space is prepared for fusion, and a spacer bone graft is inserted in the gap. The bone graft and vertebrae may be fixed in place with metal plates and screws to promote natural bone growth.
Step 6: Closing the incision
Finally, all tools are removed, and the muscle and skin incisions are closed.
Is ACDF right for me?
ACDF is used when a disc or bone spur in the neck is pressing on a nerve root or on the spinal cord, and:
- arm pain, numbness or weakness has not settled with time and non-surgical treatment such as physiotherapy and medication;
- weakness is getting worse; or
- the spinal cord is compressed (cervical myelopathy), where surgery aims to stop further damage.
ACDF suits a wider range of necks than disc replacement: one level or several, arthritic facet joints, slippage or a forward curve, and weaker bone. It is not usually recommended for neck pain on its own, without a trapped nerve or cord compression. When the pressure sits mainly behind the spinal cord, or runs along many levels, an operation from the back of the neck may suit better (see cervical spine surgeries).
Recovery after ACDF
- Hospital stay: usually one night, at American Hospital Dubai.
- The first weeks: a sore throat and some difficulty swallowing are expected at first; soft food helps. Walking every day is encouraged.
- Collar: not needed after ACDF.
- Back to work: desk work is usually possible after about 2 weeks; when to return to manual work and lifting is decided at your consultation. In one US trial, 39% of people were back at work 6 weeks after a single-level ACDF (Badve 2020).
- Driving: usually after about 2 weeks, once you can turn your head freely to check over your shoulder and are not taking painkillers that make you drowsy.
- Bone healing: the vertebrae fuse gradually over the following months, and X-rays at follow-up check the fusion. Follow-up is arranged at your consultation. Smoking slows bone healing, so stopping before surgery helps.
- Physiotherapy: decided at your consultation.
Risks of ACDF
All surgery carries risk. These are the main ones for ACDF:
- Swallowing difficulty, usually mild and improving over weeks to months. In a study of 249 people after anterior neck surgery, 50% reported some difficulty at 1 month and 12.5% at 12 months; only 4.8% had moderate or severe difficulty at 6 months (Bazaz 2002).
- Voice change: a hoarse or weak voice, usually temporary. In the same study, weakness of a vocal cord was still present at 12 months in 1.3% (Bazaz 2002).
- Non-union: the bones not fusing. Symptomatic non-union is reported in about 3% to 4% of patients in pooled studies of the first few years, with higher figures inside disc replacement trials (Wadhwa 2026), and may need a further operation.
- Adjacent segment disease: new wear at a neighbouring disc. In a long-term study of 374 patients, new symptoms at a neighbouring level appeared at about 2.9% per year, an estimated 25.6% within 10 years; the authors pointed to natural wear as the cause (Hilibrand 1999).
- Implant problems: the spacer sinking into the bone, or screws loosening.
- Rare but serious: bleeding into the neck that affects breathing, infection, injury to the gullet or windpipe, leakage of spinal fluid, and injury to a nerve root or the spinal cord.
More on complications of spinal surgery.
ACDF or disc replacement?
Cervical disc replacement removes the disc in the same way, but fits an artificial disc that keeps the level moving instead of fusing it. It suits fewer necks (healthy facet joints, good bone, usually one or two levels). For people who suit both, long-term studies show similar relief and fewer repeat operations after disc replacement (Quinto 2024). Compare them side by side: ACDF or cervical disc replacement? Read about cervical disc replacement.
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Seeing Dr Sherief Elsayed about ACDF
Dr Sherief Elsayed is a UK-trained Consultant Spinal Surgeon, FRCS (Tr & Orth). He performs both ACDF and cervical disc replacement. At your appointment he will go through your scans with you, explain which options suit your neck, including non-surgical treatment, and give you time to decide. Surgery takes place at American Hospital Dubai. Book at OrthoPro Clinic, Dubai Science Park: call 04 835 9000 or WhatsApp 052 105 2798.
FAQ
ACDF stands for Anterior Cervical Discectomy and Fusion. During this procedure, your surgeon makes a small incision at the front of your neck to reach the damaged disc. The worn or herniated disc is removed to relieve pressure on nerves or the spinal cord. The empty space is then filled with a bone graft or cage, which allows the two vertebrae to fuse together over time. A small plate and screws often hold everything stable whilst healing occurs.
No. Dr Elsayed does not use a neck collar after ACDF. Practice varies between surgeons, so you may read different advice elsewhere.
The vertebrae fuse gradually over the following months, as new bone grows through the graft and joins them. X-rays at follow-up check how the fusion is progressing, and your follow-up is arranged at your consultation. Smoking slows bone healing, so stopping helps.
Your neck movement will be somewhat reduced, but most people adapt very well. The fused segment won’t move anymore, but the levels above and below usually compensate. If only one level is fused, many patients don’t notice much difference in daily activities like driving or looking around. Two-level fusions may cause slightly more stiffness. The relief from pain and other symptoms typically outweighs any reduction in flexibility. Your neck will feel stiff initially, but this improves as you heal.
Adjacent segment disease, where a disc next to the fusion wears and causes new symptoms, was found in a long-term study of 374 patients at about 2.9% per year, an estimated 25.6% within 10 years (Hilibrand 1999). The authors pointed to natural wear (spondylosis) as the cause. Not everyone with changes on a scan needs further surgery. Your age, the number of levels and the condition of the neighbouring discs all affect the risk.