ACDF vs Total Disc Replacement

In this video, spine surgeon Dr. Kern Singh explains the differences between Anterior Cervical Discectomy and Fusion (ACDF) and Total Disc Replacement.

A common question patients ask Dr. Kern Singh is when to choose a cervical fusion versus an artificial disc replacement. His answer is almost always emphatically to choose artificial disc replacement. An artificial disc replacement allows patients to preserve motion in the neck. Conceptually, it can be thought of as a hip or knee replacement for the neck. It consists of a titanium endplate with a plastic spacer, enabling movement forward, backward, and side to side. There are only a few instances where Dr. Kern Singh recommends a cervical fusion—typically in patients with trauma, deformity, or misalignment of the neck, or in cases where they have previously undergone a fusion. However, even in these situations, he can often still perform a cervical disc replacement instead. In general, whenever possible, Dr. Kern Singh recommends disc replacement over fusion.