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Anterior Cervical Discectomy and Fusion (ACDF)-Outpatient

Anterior cervical discectomy and fusion (ACDF) is a type of neck surgery. This procedure is done to remove one or more bulging, damaged or degenerated cervical disc(s) in your neck. The neck is also known as the cervical spine. Cervical discs act as shock absorbers or cushions between your neck bones (vertebra). These discs help with movement and bending.

 

We will remove your damaged disc and replace it with a bone graft or synthetic spacer.  We may also add a titanium plate and/or screws to your spine.  We do this so your spine is stable right away. Over time, this will grow into a solid unit called a fusion.

 

Before Your ACDF Surgery (Pre-Op)

  • As you prepare for this surgical procedure, your surgeon will need to know your medical history. This is done to find out if there is anything that can greatly affect your safety. The surgeon needs this information for anesthesia and your bone healing after surgery.
  • Check with your surgeon to learn which medications you can or cannot take before your procedure. Certain medications can cause bleeding. For this reason, you may need to stop taking these medications one  week before surgery.  Examples of these medications are:  Advil®, Aleve®, aspirin, ibuprofen, blood thinners, vitamins, herbal medications, supplements, etc.
  • Your surgeon will discuss with you the possible risks associated with ACDF. Also, your surgeon will let you know what to expect and how you may feel after surgery.

 

After Your ACDF Surgery (Post-Op)

  • After surgery, you will wake up in the PACU (post-operative recovery area). There a nurse will monitor your vital signs while your anesthesia wears off. These vitals are: blood pressure, heart rate, pulse oxygen, temperature, breathing rate and pain level.
  • You will probably stay in the PACU for up to 4 hours after surgery before being discharged home.
  • If your team has any medical concerns, you may need to stay overnight.
  • It is normal to have discomfort at your incision site right after surgery. If you have any pain, we will treat it at this time. We will also discuss your discharge plan.
  • Once the spine team feels that you are doing well, you will be discharged home from the PACU.
  • Your spine team will discuss with you any pain medications to take at home. They will also discuss wound care instructions, exercises, physical therapy (PT), collar wear and any activity restrictions, if needed.
  • You will probably be up and walking - including going to the bathroom at home.
  • You may not need physical therapy (PT) after surgery.
  • You may return to your regular activities usually within 2-4 weeks after surgery. Discuss this with your surgeon.
  • You may return back to office type work within 1-3 weeks after surgery. Return to manual labor is usually 2-3 months after surgery. Discuss going back to work with your surgeon.
  • Limit activities that require much bending or twisting of the neck for 4 weeks after surgery.
  • You can start your exercise routine again shortly after surgery. Do not do strenuous exercise until 6 weeks after surgery. Discuss this with your surgeon.

 

Common Questions 

When will I go home?

We will discharge you home the same day of your surgery. This will happen if the spine team feels you are doing well.

 

Will I be able to eat after surgery?

You will probably have difficulty swallowing for a few weeks after surgery.  You may also have pain when swallowing.  This difficulty should go away as your swelling goes down. Drink liquids with bubbles like ginger ale and eat small bites of food. These will be easier for you to swallow. 

 

What kind of pain medication can I take after surgery?

We will give you a prescription for an opioid pain medication such as Percocet®. We will also prescribe a stool softener for constipation (as this can be a side effect of taking opioids). As the pain goes away in the first few days, we strongly advise to stop taking both of them. You can then take Tylenol® for pain as needed. Do not take non-steroidal anti-inflammatory drugs (NSAIDs) such as Aleve®, Advil®, Celecoxib, ibuprofen, Ketorolac, Naproxen, etc., for 3 months after your surgery. NSAIDs interfere with the healing of your fusion. Your surgeon will discuss this with you.

 

Do I need physical therapy (PT) when I go home?

Most patients will not need PT after their discharge home.  Your surgeon will assess the need for PT during your first post-op visit.

 

When can I shower?

You can bathe and shower after surgery. However, you need to keep your incision site (wound) dry. You need to do this for 5 days after surgery. Keeping your incision site dry will help your healing process. 

 

How do I take care of my incision?

You can remove the outer bandage over the incision site 2 days after surgery. The Steri-Strips underneath your outer bandage will probably fall off in the shower. This will happen within 2 weeks after surgery. If not all of your Steri-Strips have fallen off by themselves, your surgeon will remove them. This will happen during your first post-op visit. 

 

Will I have a scar?

You will have a small scar that fades over time.  You may only use creams and ointments (like Vitamin E cream) to improve your scar’s appearance. You can do this once your scar has healed well. Discuss this with your surgeon.

 

Will I have to wear a collar after surgery?

Your surgeon will send you home wearing either a soft or hard collar.  If you have a soft collar, it is mainly for comfort. You can remove it when you feel it is ok.  If you have a hard collar, you can only remove it after discussing this with your surgeon.

 

When can I drive?

Do not drive while you are wearing a collar. Also, do not drive while taking your prescribed pain medications (opioids) as they can make you drowsy.  Please discuss driving with your surgeon during your first post-op visit.

 

When can I travel by plane?

You need to discuss with your surgeon when it is safe to travel by plane.

 

What will be my activity level?

You will be able to rest and move around your home after surgery. You will be able to get back to your light, non-strenuous daily activities. This will happen about 2-3 days after your surgery.

 

When should I call my surgeon?

You should call your surgeon if you have any of the following signs or symptoms:

  • Chills or fever of 101.5°F (38.6°C) or higher
  • Increased neck swelling, bleeding, redness or discharge from your incision site
  • Pain that does not go away with prescribed pain medication (opioids)

 

When should I call 911?

Call 911 for an ambulance to take you to an emergency department if you have the following signs or symptoms:

  • Shortness of breath, difficulty breathing
  • Severe difficulty swallowing
  • Chest pain

 

© NYU Langone Health. All rights reserved. Reviewed for health literacy. This information is not intended as a substitute for professional medical care. Always follow your health care provider's instructions.