Published by Commons Clinic. [Web version](https://commonsclinicreviews.com/articles/neck-surgery-acdf-disc-replacement-posterior/) Reviewer names are abbreviated. Patient reviews describe individual experiences. Review counts describe source records, not unique patients or clinical outcomes; the acquired snapshot may not include complete platform histories. Clinical education and patient accounts do not replace a consultation. Spine # ACDF, disc replacement or posterior surgery: 6 questions to compare options Several neck operations can address a compressed nerve, but they change different structures and are not interchangeable. A useful comparison starts with your anatomy, the symptom being treated, and the tradeoffs that matter in daily life. Published by Commons Clinic · Updated October 21, 2026 · 4 min read [Questions to ask ↓](https://commonsclinicreviews.com/articles/neck-surgery-acdf-disc-replacement-posterior/#consultation-questions) [Patient experiences ↓](https://commonsclinicreviews.com/articles/neck-surgery-acdf-disc-replacement-posterior/#patient-experiences) In this guide 1. [Compare the problem before comparing the operation names](https://commonsclinicreviews.com/articles/neck-surgery-acdf-disc-replacement-posterior/#guide-section-1) 2. [Understand what ACDF changes](https://commonsclinicreviews.com/articles/neck-surgery-acdf-disc-replacement-posterior/#guide-section-2) 3. [Ask what makes disc replacement a reasonable option](https://commonsclinicreviews.com/articles/neck-surgery-acdf-disc-replacement-posterior/#guide-section-3) 4. [Clarify what a posterior operation can address](https://commonsclinicreviews.com/articles/neck-surgery-acdf-disc-replacement-posterior/#guide-section-4) 5. [Compare tradeoffs in your own circumstances](https://commonsclinicreviews.com/articles/neck-surgery-acdf-disc-replacement-posterior/#guide-section-5) 6. [Leave with the reason for the recommendation](https://commonsclinicreviews.com/articles/neck-surgery-acdf-disc-replacement-posterior/#guide-section-6) [Go to your consultation questions ↓](https://commonsclinicreviews.com/articles/neck-surgery-acdf-disc-replacement-posterior/#consultation-questions) [![Matched cervical spine cross-sections highlight the central spinal cord and an exiting nerve root.](https://commonsclinicreviews.com/assets/medical/cord-versus-root.webp)](https://commonsclinicreviews.com/assets/medical/cord-versus-root.webp) **Spinal cord and nerve roots** Original educational illustration. Matched cervical spine cross-sections highlight the central spinal cord and an exiting nerve root. Cord and nerve-root problems can have different implications. Symptoms, examination and imaging are considered together; this orientation drawing cannot diagnose the source of numbness or weakness. Illustration references: [Reference 1](https://www.orthoinfo.org/diseases--conditions/cervical-spondylotic-myelopathy-spinal-cord-compression/) · [Reference 2](https://www.orthoinfo.org/diseases--conditions/cervical-radiculopathy-pinched-nerve/) ## 1. Compare the problem before comparing the operation names Ask the surgeon to point to the affected level and explain whether the main concern involves a nerve root, the spinal cord, or both. An operation intended to relieve arm symptoms may have different goals from one intended to address spinal-cord compression. Your conversation should identify the problem in a sentence you can repeat without relying on an acronym. Bring a short list of priorities: using your hand, sleeping through arm pain, walking more steadily, or returning to a particular task. Ask which of these the proposed operation is expected to help and which may need a separate plan. That distinction is more useful than a general promise of a better neck. Sources: [Cervical Radiculopathy: Surgical Treatment Options](https://www.orthoinfo.org/treatment/cervical-radiculopathy-surgical-treatment-options) · [Cervical Radiculopathy (Pinched Nerve)](https://www.orthoinfo.org/diseases--conditions/cervical-radiculopathy-pinched-nerve/) ## 2. Understand what ACDF changes Anterior cervical discectomy and fusion, or ACDF, reaches the spine from the front of the neck, removes the relevant disc, and joins the treated vertebrae. Ask how many levels are included and why a fusion is being recommended for your findings. Hardware, a spacer, and bone healing serve different roles; ask the surgeon to show each on a diagram. The practical discussion is about your proposed operation, not every possible fusion. Would the same number of levels be treated with another approach? What does the team expect you to notice about movement? Which symptoms may remain despite a technically successful operation? Write down any uncertainty that matters to your decision. Sources: [Cervical Radiculopathy: Surgical Treatment Options](https://www.orthoinfo.org/treatment/cervical-radiculopathy-surgical-treatment-options) · [ACDF: Surgery for Cervical Radiculopathy and Neck Pain](https://www.hss.edu/health-library/conditions-and-treatments/acdf-surgery) ## 3. Ask what makes disc replacement a reasonable option Cervical disc replacement uses an artificial disc with the aim of maintaining movement at the treated level. It is an option for selected patients, not a general upgrade from fusion. Ask which features of your joints, alignment, bone, and affected levels support or limit its use. If you have read a favorable study or testimonial, ask whether those patients resembled you. Request a discussion of device-specific considerations, the surgeon's experience with the proposed implant, and what follow-up would involve. A useful answer should explain why preserving motion is relevant in your case rather than treating movement as the only outcome that matters. Sources: [Cervical Radiculopathy: Surgical Treatment Options](https://www.orthoinfo.org/treatment/cervical-radiculopathy-surgical-treatment-options) ## 4. Clarify what a posterior operation can address A posterior cervical laminoforaminotomy approaches the area from the back of the neck and can create space for a nerve in selected circumstances. Ask where the compression sits and whether the planned access can address it adequately. Not every posterior operation is the same, and some neck conditions require a different procedure or stabilization. Have the surgeon label what would be removed, preserved, or added. Ask how the proposal changes if there is more than one affected level or another source of symptoms. This prevents a misleading comparison between an extensive operation on one side of the table and a narrowly targeted procedure on the other. Sources: [Cervical Radiculopathy: Surgical Treatment Options](https://www.orthoinfo.org/treatment/cervical-radiculopathy-surgical-treatment-options) ## 5. Compare tradeoffs in your own circumstances Each approach has a distinct set of concerns. With anterior neck surgery, swallowing and voice changes belong in the discussion. With any proposed operation, ask about nerve or spinal-cord injury, infection, incomplete relief, and possible further surgery. The team should explain which concerns are most relevant to your anatomy and health. Discuss your work, caregiving, previous neck surgery, and any existing swallowing or voice problem. Ask what recovery would require from someone living alone or relying on public transportation. Prefer a side-by-side explanation of restrictions and follow-up over a ranking based on incision size or an advertised recovery time. Sources: [ACDF: Surgery for Cervical Radiculopathy and Neck Pain](https://www.hss.edu/health-library/conditions-and-treatments/acdf-surgery) · [Cervical Radiculopathy: Surgical Treatment Options](https://www.orthoinfo.org/treatment/cervical-radiculopathy-surgical-treatment-options) ## 6. Leave with the reason for the recommendation Ask whether continued nonsurgical care remains reasonable, what would make the decision more urgent, and what could change the recommendation. A second opinion is most useful when it reviews the same images and answers the same questions. New or worsening neurological changes should be assessed promptly rather than waiting for a comparison appointment. At the end, summarize what you heard: the target, the chosen approach, the main alternative, and the expected limits. Invite the surgeon to correct your understanding. You do not need to know every technical detail, but you should understand why this operation is being proposed for you. Sources: [Cervical Radiculopathy (Pinched Nerve)](https://www.orthoinfo.org/diseases--conditions/cervical-radiculopathy-pinched-nerve/) · [Cervical Spondylotic Myelopathy (Spinal Cord Compression)](https://www.orthoinfo.org/diseases--conditions/cervical-spondylotic-myelopathy-spinal-cord-compression/) Make the most of your visit ## Questions to bring to your consultation Choose the questions that matter most to you. Bring them along, and ask us to explain anything that is unclear. - Is the main concern my nerve root, spinal cord, or both? - Why do you recommend this approach for the exact levels involved? - What makes me eligible or ineligible for disc replacement? - Could a posterior approach address the same problem adequately? - Which symptoms are least likely to improve with this operation? - How do my existing swallowing, voice, or bone-health issues change the plan? - What would make waiting or continuing nonsurgical care unsafe? ## Sources & further reading - [Cervical Radiculopathy: Surgical Treatment Options](https://www.orthoinfo.org/treatment/cervical-radiculopathy-surgical-treatment-options) AAOS OrthoInfo - [Cervical Radiculopathy (Pinched Nerve)](https://www.orthoinfo.org/diseases--conditions/cervical-radiculopathy-pinched-nerve/) AAOS OrthoInfo - [ACDF: Surgery for Cervical Radiculopathy and Neck Pain](https://www.hss.edu/health-library/conditions-and-treatments/acdf-surgery) Hospital for Special Surgery - [Cervical Spondylotic Myelopathy (Spinal Cord Compression)](https://www.orthoinfo.org/diseases--conditions/cervical-spondylotic-myelopathy-spinal-cord-compression/) AAOS OrthoInfo We use these medical sources to help explain your options and prepare you for a conversation with our team. Our guides feature our own clinicians; patient reviews describe individual experiences. [Read as Markdown](https://commonsclinicreviews.com/articles/neck-surgery-acdf-disc-replacement-posterior/index.md) Meet our team ## People behind your care. [**Amandeep Bhalla, MD** Orthopedic Surgeon, Spine](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) [More about Amandeep Bhalla ↗](https://commonsclinic.com/physicians/amandeep-bhalla-m-d/) [**Brandon A. Ortega, MD** Orthopedic Surgeon, Spine](https://commonsclinicreviews.com/physicians/brandon-ortega-md/) [More about Brandon A. Ortega ↗](https://commonsclinic.com/physicians/brandon-ortega-md/) [**Hyun Bae, MD** Orthopedic Surgeon, Spine](https://commonsclinicreviews.com/physicians/hyun-bae-md/) [More about Hyun Bae ↗](https://commonsclinic.com/physicians/hyun-bae-md/) [**Sanjay Khurana, MD** Orthopedic Surgeon, Spine](https://commonsclinicreviews.com/physicians/sanjay-khurana-md/) [More about Sanjay Khurana ↗](https://commonsclinic.com/physicians/sanjay-khurana-m-d/) Explore our clinicians, then talk with us about your symptoms, goals, and the care you need. Patient experiences ## Meet the clinician. *Hear the experience.* Read how patients describe their care, then bring the questions that matter to your own visit. Each portrait stays with that clinician’s accounts. [![Brandon A. Ortega, MD](https://commonsclinicreviews.com/assets/brandon-ortega-md.jpg)](https://commonsclinicreviews.com/physicians/brandon-ortega-md/) ## [Brandon A. Ortega, MD](https://commonsclinicreviews.com/physicians/brandon-ortega-md/) Orthopedic Surgeon, Spine [Biography & all reviews →](https://commonsclinicreviews.com/physicians/brandon-ortega-md/) [Commons Clinic profile ↗](https://commonsclinic.com/physicians/brandon-ortega-md/) Excerpt > I trusted Dr. Ortega to perform Neck Cervical Radiculopathy ACDF. He is an amazing, wonderful and dedicated surgeon. N. Villalta Rating: 5/5 · Source: Google · Date: February 21, 2026 [Reviewer’s Google activity](https://www.google.com/maps/contrib/107279659275756703773/place/ChIJTxvcSygz3YARoijXeBhzhh8) Source link type: reviewer place Attributed clinician: Brandon A. Ortega, MD The reviewer shares their experience of care. [![Amandeep Bhalla, MD](https://commonsclinicreviews.com/assets/amandeep-bhalla-m-d.jpg)](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) ## [Amandeep Bhalla, MD](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) Orthopedic Surgeon, Spine [Biography & all reviews →](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) [Commons Clinic profile ↗](https://commonsclinic.com/physicians/amandeep-bhalla-m-d/) Excerpt > I trust him and his expertise. Between cervical fusion and lumbar issues, he is caring, kind and always lovely to talk too. B. Kazarian Rating: 5/5 · Source: Google · Date: May 24, 2021 [Reviewer’s Google activity](https://www.google.com/maps/contrib/117026212474365215451/place/ChIJ8YAf0pAz3YARGxtBH2uG-xA) Source link type: reviewer place Attributed clinician: Amandeep Bhalla, MD The reviewer shares their experience of care. Excerpt > He gave me options and I'm so grateful I chose surgery (ACDF) - pain free and feeling great! Thanks Dr. Bhalla! S. Sternagle Rating: 5/5 · Source: Google · Date: May 10, 2019 [Reviewer’s Google activity](https://www.google.com/maps/contrib/109356386157216697150/place/ChIJ8YAf0pAz3YARGxtBH2uG-xA) Source link type: reviewer place Attributed clinician: Amandeep Bhalla, MD The reviewer shares their experience of care. [![Sanjay Khurana, MD](https://commonsclinicreviews.com/assets/sanjay-khurana-m-d.jpg)](https://commonsclinicreviews.com/physicians/sanjay-khurana-md/) ## [Sanjay Khurana, MD](https://commonsclinicreviews.com/physicians/sanjay-khurana-md/) Orthopedic Surgeon, Spine [Biography & all reviews →](https://commonsclinicreviews.com/physicians/sanjay-khurana-md/) [Commons Clinic profile ↗](https://commonsclinic.com/physicians/sanjay-khurana-m-d/) Excerpt > Dr. Khurana is the best. I am 38 years old, and just recently had a ACDF C5/6 and I feel great. S. K. Rating: 5/5 · Source: Yelp · Date: October 21, 2017 [Read review on Yelp](https://yelp.com/biz/sanjay-khurana-md-marina-del-rey?hrid=FKD9Rvbu-gpTX5flsKmceQ&utm_medium=copy_link&utm_source=biz_post_share&l=en_US) Source link type: verified permalink Attributed clinician: Sanjay Khurana, MD The reviewer shares their experience of care. Excerpt > He did a fantastic job with my husband's cervical fusion back in January. He has a great bedside manner. B. B. Rating: 5/5 · Source: Yelp · Date: June 17, 2015 [Read review on Yelp](https://yelp.com/biz/sanjay-khurana-md-marina-del-rey?hrid=SV9TOJRKJF11jwObN-duWA&utm_medium=copy_link&utm_source=biz_post_share&l=en_US) Source link type: verified permalink Attributed clinician: Sanjay Khurana, MD A family member shares their experience of the care provided. [![Hyun Bae, MD](https://commonsclinicreviews.com/assets/hyun-bae-md.jpg)](https://commonsclinicreviews.com/physicians/hyun-bae-md/) ## [Hyun Bae, MD](https://commonsclinicreviews.com/physicians/hyun-bae-md/) Orthopedic Surgeon, Spine [Biography & all reviews →](https://commonsclinicreviews.com/physicians/hyun-bae-md/) [Commons Clinic profile ↗](https://commonsclinic.com/physicians/hyun-bae-md/) Excerpt > Today I am post-op day 4 ( anterior cervical disc replacement and hybrid fusion on another level)- I feel amazing. R. A. Rating: 5/5 · Source: Yelp · Date: October 3, 2014 [Read review on Yelp](https://yelp.com/biz/hyun-bae-md-santa-monica?hrid=JzYexfxiR44QWT9i1CJtzQ&utm_medium=copy_link&utm_source=biz_post_share&l=en_US) Source link type: verified permalink Attributed clinician: Hyun Bae, MD The reviewer shares their experience of care. Keep exploring ## Your next *good question.* More guidance to help you understand your options and plan your next step. Spine ### [8 things to compare before choosing a spine surgeon](https://commonsclinicreviews.com/articles/choosing-spine-surgeon/) Build your shortlist around your condition, the explanation you receive, and the care you will need. These eight comparisons can help you turn a broad search into a useful consultation. [Read the guide](https://commonsclinicreviews.com/articles/choosing-spine-surgeon/) Spine ### [7 questions to clarify an opinion about spine surgery](https://commonsclinicreviews.com/articles/spine-surgery-second-opinion/) A second opinion can confirm a plan or reveal a useful difference. Prepare the same records and questions so you can understand where the recommendations agree—and why they may differ. 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[Read the guide](https://commonsclinicreviews.com/articles/lumbar-fusion-approaches-alif-tlif-lateral/) Meet the clinicians ## Explore your *next conversation.* [![Amandeep Bhalla, MD](https://commonsclinicreviews.com/assets/amandeep-bhalla-m-d.jpg)](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) Orthopedic Surgeon, Spine ### [Amandeep Bhalla, MD](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) Long Beach – Bixby Knolls [Meet Amandeep Bhalla](https://commonsclinicreviews.com/physicians/amandeep-bhalla-md/) [![Brandon A. Ortega, MD](https://commonsclinicreviews.com/assets/brandon-ortega-md.jpg)](https://commonsclinicreviews.com/physicians/brandon-ortega-md/) Orthopedic Surgeon, Spine ### [Brandon A. Ortega, MD](https://commonsclinicreviews.com/physicians/brandon-ortega-md/) Long Beach – Douglas Park [Meet Brandon A. 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