What is ACDF?
ACDF is anterior cervical discectomy and fusion, which is a minimally invasive surgery done on the neck to relieve symptoms from a degenerative disc or bulging disc in the neck. Anterior cervical discectomy and fusion is done on an outpatient basis and this surgical procedure has about 90 to 100% success rate in relieving patient's symptoms. The recovery time post ACDF surgery is about 4 to 6 weeks and there is a low complication risk with this procedure. ACDF is very beneficial for patients who don't find relief from conservative treatment and physical therapy.
What is the Recovery Time Following ACDF?
The recovery time following ACDF varies. The average recovery time is 4 to 6 weeks. Some patients can to return to their daily activities within a week after the ACDF surgery. Some patients may need to start physical therapy about a month after ACDF and continue it for a couple more months. Usually after 3 weeks post ACDF, patients are allowed to do light work. Lifting weights should be avoided. Patient should not overdo the activities and take regular breaks and rest if he/she feels tired. For a complete and healthy recovery from ACDF, patient should perform physical therapy, adopt good posture, along with proper lifestyle and weight management. All these things are essential for cutting down on the recovery time from ACDF.
What to Expect After ACDF Surgery:
Discomfort: Immediately after the ACDF surgery, patient experiences discomfort in swallowing and hoarseness after the surgery. This can be present for a few weeks following ACDF. The symptoms for which ACDF was done will take about a month to completely recover.
Neck & Body Movement: Patient has increased mobility of the head if the fusion is done of a single level of vertebrae. If the fusion is done of two or more levels then it causes a problem with the neck movements. Healing of the deep stitches muscles and soft tissues takes a minimum of 6 weeks. So, it is important to restrict neck movements during this period. Repetitive and sudden movements should be avoided.
Wound Care: Absorbable stitches are used to close majority of the wounds after ACDF is done. There is placement of multiple strips of tape along the edges of the wound to keep them closed for proper healing and these strips should be allowed to fall off on their own. If the wound gets wet during bathing, then it should be patted dry using a clean cloth. The dressing should be frequently changed if it is getting soiled or if the wound is draining blood-tinged fluid.
Return to Work: Patient's return to work depends on the type of surgery done and the recovery of the patient. Some patients can return to work as early as 4 to 5 days following ACDF. The best person to decide when the patient can return to work following ACDF is the patient's surgeon. The surgeon can also advise on work modifications if any are needed for the patient.
Lifting: Patient is not permitted to lift more than 8 pounds of weight during the first 6 weeks after ACDF and should avoid reaching over head activities and heavy lifting.
Bathing: Patient should take only showers in the initial 2 weeks after the ACDF surgery, as entering and exiting a bathtub puts strain on the neck. It is also advantageous to use a shower-seat to avoid the risk of slipping or falling.
Diet: Following ACDF surgery, Patient needs lot of protein to allow the bone to grow into a solid fusion between the 2 vertebrae. If protein rich diet is not taken, then the muscles tend to get more fatigued and are not able to function properly. Patient should increase his/her protein intake in diet in the initial 4 months post ACDF. Some of the protein-rich foods consist of: Dairy products, eggs, fish, turkey, chicken and red meats. Patient should also follow a well balanced diet to speed up the healing and recovery time following ACDF.
Weight Gain/Loss: Patient may gain or lose weight in the initial few months following ACDF or any other surgery for that matter. Weight loss can occur from decreased calorie intake and poor appetite; and weight gain can occur from decreased activity. All this will improve slowly as the patient recovers following ACDF.
Fatigue: Patient feels tired and fatigued for up to 4 months following ACDF. This is because of de-conditioning, anemia and in some cases situational depression. Symptoms resolve as the patient recovers.
Braces/Collars: These can be worn for providing support/immobilization to the neck and to speed up the recovery process following ACDF. They can be worn for a month to 2 months after ACDF.
Driving: Most of the patients are allowed to drive about 2 weeks following ACDF surgery provided patient is not wearing a collar post surgery. If a collar needs to be worn for prolonged period of time, then patient is not allowed to drive.
Smoking: Patient should avoid smoking, as it is harmful for spinal fusion and hinders its formation. Smoking should be started only after the fusion is solid, which can take up to 6 months following ACDF.
Medications: Certain medications affect the spinal fusion process and should be avoided for at least 6 months after the surgery and should be given only when absolutely necessary. The medications to be avoided include non-steroidal anti-inflammatory medications and oral cortisone preparations.
Follow up Visits: Patient needs to regularly follow-up with their surgeon post ACDF, so their recovery can be assessed by taking x-rays to determine the progress of the spinal fusion.
Physical Therapy: Physical therapy is an important part of patient's recovery period. It can be usually started about a month to 3 months following ACDF. Patient is told to perform stretching exercises initially to increase flexibility. Mild aerobic exercises are then done to improve the body's conditioning. After this resistance training can be started using weights to improve stability and strength of the body and neck. Physical therapy following ACDF commonly consists of ice therapy, massage, electrical stimulation, Transcutaneous Electrical Nerve Stimulators (TENS) etc.