Anterior Cervical Discectomy with Fusion Instructions

  • Call 913-955-3300 to make an appointment
  • Ask for Kellie, RN-ARNP for any questions 913-955-3300
  • Surgical procedure information can be viewed at: UnderstandSpineSurgery.com

Stenosis can occur in any portion of the spine and is caused by degenerative changes in the disc space, bones,
and ligament structures. As the degeneration occurs, the space for the nerve roots becomes compressed.
Symptoms are related to the area of compression. In the cervical area the symptoms can range from pain,
numbness and tingling in both or one arm as well as difficulty walking distances, difficulty fixing hair, buttoning
buttons, and holding objects in your hands.

Anterior cervical discectomy with fusion (ACDF) is performed to remove the degenerative disc and bone spurs from
around the compressed nerves and spinal cord. This may be performed at one or more levels depending on the
examination. The surgery takes 45 minutes to 1 ½ hours, depending on the levels involved. The incision is placed
on the front of the neck typically on the right side along a natural wrinkle crease; it is approximately 2 ½ inches in
length. The disc is removed from the front to decompress the nerve roots and spinal cord. Inter-body fusion bone
is placed into the area of the former disc space to maintain the height between the vertebrae where the disc was
located. The nerve roots are examined to ensure adequate decompression. The muscle and tissue are closed and
sutured and the incision is closed. The skin is closed and steri-strips are placed over the incision. A final dressing
is placed.

A soft cervical collar may be placed to be worn for 1 week, and then removed. It is ok to remove the collar for
showering. The first shower is in 48 hours and the overlying dressing can be removed from the incision and the
incision is allowed to get wet. Pat the incision dry and you may leave the incision and steri-strips exposed to air.
Replace the collar once skin is dry.

Many patients notice a mild hoarseness or sore throat after surgery. This will usually resolve in a few days. Occasionally patients may notice swallowing difficulty that may persist for several weeks. You are encouraged to drink plenty of fluids. If swallowing is difficult to
the point you cannot drink water, then call and let us know; this is extremely rare.

Generally, you will be discharged from the recovery room or in the hospital overnight. Rehabilitation may be
involved to assist with teaching you post-operative neck education.

Ice packs to the front and back of the neck will help with muscular pain control. You may also apply a topical muscle
rub to the back of the neck as needed for relaxation. Ice is used for 45 minutes every 3-4 hours for the first 72
hours, then can be changed to heat to the back of the neck as needed. No Ibuprofen or Aleve products after a
fusion since they suppress the anti-inflammatory response and this is needed for the fusion to heal over time.
These can be resumed in about 6 months.

Activity is as you tolerate. Light activity around the house for the first few days; then set about a walking program
daily. Start slow and increase the distance on a weekly basis. Be consistent with activity throughout the week. No
activity that puts you into a prolonged head-down position such as reading, computer, or needle-craft work. Lifting,
pushing, pulling is restricted to 10 lbs for the first month. You can expect to have some discomfort in the neck and
arms as you increase activity. Driving can generally be resumed in 1 week. Physical Therapy is recommended on a
case-by-case evaluation. Participation and resuming sports and exercise programs should be addressed during
your follow-up appointments. Returning to work is based on individual evaluation.

You will have a narcotic medication for pain and may also have a muscle relaxant. The medication will be weaned
over the following days to weeks as you increase your activity and decreased pain is attained. You should not
require long-term narcotic pain relievers. To avoid constipation, please drink plenty of fluids, juices, and add stool
softeners and laxatives as needed.

You can expect a variety of post-operative pain, numbness, and tingling as the nerve and muscle heal. Be
consistent with your medication, activity, and adjunctive treatment with ice, heat, and rubs. Monitor the incision for
signs of redness, swelling, and drainage over the next week and notify us of any concern. Fever more than 101.5
degrees after 3 days should be reported.

Smoking cessation information is available at the hospital. Smoking increases the possibility of fusion failure and
increases degenerative disease of the disc. Smoking cessation is strongly advised.

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