ACDF Surgery

Your surgeon and anesthesiologist will use general anesthesia to help you remain unconscious throughout the entire surgery. Talk to your doctor about the possible complications of surgery before you have ACDF surgery, such as blood clots or infections.

An ACDF surgery can take one to four hours depending on your condition and the number of disks to be removed.

To perform an ACDF surgery, your surgeon:

1. Makes a small cut on the front of your neck.
2. Moves your blood vessels, food pipe (esophagus), and windpipe (trachea) aside to see your vertebrae.
3. Identifies the affected vertebrae, disks, or nerves and takes X-rays of the area (if they haven’t done so already).
4. Uses tools to take out any bone spurs or disks that are damaged or pushing on your nerves and causing pain. This step is called diskectomy.
5. Takes a piece of bone from somewhere else in your neck (autograft), from a donor (allograft), or uses a synthetic compound to fill in any empty space left behind by the removed bone material. This step is called bone graft fusion.
6. Attaches a plate and screws made of titanium to the two vertebrae around the area where the disk was removed.
7. Puts your blood vessels, esophagus, and trachea back in their usual place.
8. Uses stitches to close the cut on your neck.

ACDF surgery is mainly used to:

• Remove a disk in your spine that has become worn down or injured.
• Remove bone spurs on your vertebrae that pinch your nerves. Pinched nerves can make your legs or arms feel numb or weak. So treating the source of the compressed nerve in your spine with ACDF surgery can relieve or even end this numbness or weakness.
• Treat a herniated disk, sometimes called a slipped disk. This happens when soft material in the center of a disk is pushed out through the firmer material on the outer edges of a disk.

During the weeks leading up to the surgery:

• Attend any scheduled appointments for blood tests, X-rays, or electrocardiogram (ECG) tests.
• Sign a consent form and share your medical history with your doctor.
• Tell your doctor about any medications or dietary supplements, herbal or otherwise, that you’re currently taking.
• Don’t smoke before the procedure. If possible, try to quit six months before your surgery, as smoking can slow down the healing process. This includes cigarettes, cigars, chewing tobacco, and electronic or vapor cigarettes.
• Don’t drink any alcohol about a week before the procedure.
• Don’t take any nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), or blood thinners, such as warfarin (Coumadin), about a week before the procedure.
• Get a few days off work for the surgery and recovery.

On the day of the surgery:

• Don’t eat or drink for at least eight hours before the procedure.
• Shower and dress in clean, loose clothing.
• Don’t wear any jewelry to the hospital.
• Get to the hospital two to three hours before your surgery is scheduled.
• Make sure a family member or close friend can take you home.
• Bring written instructions regarding any medications or supplements that you need to take and when to take them.
• Follow your doctor’s instructions as to whether to take your normal medication. Take any necessary medications with only a small amount of water.
• Pack any important belongings in a hospital bag in case you need to stay overnight after the surgery.

After surgery, you’ll wake up in the postoperative care unit and then be moved to a room where your heart rate, blood pressure, and breathing will be monitored. Hospital staff will help you sit up, move, and walk around until you feel comfortable.

Once you’re able to move normally, your doctor will assess your condition and release you from the hospital with prescriptions for pain and bowel management, as pain medications can cause constipation.

If you have trouble breathing or your blood pressure hasn’t returned to normal, your doctor might recommend that you stay in the hospital overnight.

See your surgeon about two weeks after your surgery for a follow-up appointment. You should be able to do daily activities again in four to six weeks.

See your doctor right away if you notice any of the following:

• high fever at or above 101°F (38°C)
• bleeding or discharge from the surgery site
• abnormal swelling or redness
• pain that doesn’t go away with medication
• weakness that wasn’t present before the surgery
• trouble swallowing
• intense pain or stiffness in your neck

After you leave the hospital:

• Take any medications that your doctor prescribes for pain and constipation. These may include narcotics, such as acetaminophen-hydrocodone (Vicodin), and stool softeners, such as bisacodyl (Dulcolax).
• Don’t use any NSAIDs for at least six months.
• Don’t lift any objects over 5 pounds.
• Don’t smoke or drink alcohol.
• Don’t look up or down using your neck.
• Don’t sit for long periods of time.
• Have someone help you with any activities that may strain your neck.
• Wear a neck brace according to your doctor’s instructions.
• Attend regular physical therapy sessions.

Don’t do the following until your doctor tells you it’s okay:

• Have sex.
• Drive a vehicle.
• Swim or take baths.
• Do strenuous exercise, such as jogging or lifting weights.

Once your graft starts to heal, walk short distances, starting at about 1 mile and regularly increasing the distance, every day. This light exercise can aid in your healing process.

ACDF surgery is often highly successful and can help you gain control of your neck and limb movement again. Recovery can take a long time, but the relief of pain and weakness can allow you to return to many daily activities that you love to do.