Anterior cervical fusion surgery (ACDF) is generally a quick surgery to recover from. There are variables that can make the surgery take longer to heal. Posterior neck discomfort immediately after ACDF surgery is normal. The level or levels chosen for surgery have quite frequently collapsed after years of degenerative changes. Surgery restores these levels to their previous normal heights (yes, many patients get taller after surgery). The posterior ligaments have contracted from years of shortening and tend to cause temporary discomfort when stretched back to their natural lengths. This symptom occurs in about 25-40% of patients and subsides after hours to days.
Some patients develop dysphagia, swallowing difficulty after surgery for some days to weeks. The esophagus which is made of muscle is retracted during surgery. Muscle can dysfunction after retraction and swallowing is a coordinated muscle contraction to push food into the stomach. Some dysfunction can feel like food is getting caught. This feeling normally goes away after time. If swallowing is an issue, especially with pills, use a thicker liquid to swallow with. Yogurt or a smoothie can make swallowing much easier.
You will be given 2 neck collars after surgery, a Miami J and a Philadelphia collar. The Miami J is white and blue- made out of hard plastic and padding and the Philly collar is a pink medium foam. Use the Miami J for daily use and the Philly for showering. After the shower, first dry your hair. Then sit upright, remove the Philly collar keeping your head still, towel dry your neck and put the Miami collar on. The Philly collar will be dry for the next shower’s use.
After approximately 1 week, you will be able to remove the collar and go without it during the day. Wearing the collar is recommended when you sleep so you don’t hold your neck in torqued or uncomfortable positions. Some individuals like the collar and can wean out of it more slowly.
The grafts normally need at least 6 weeks to heal in (if autograft) and longer if allograft (cadaver bone). Physical therapy will be started at about 6 weeks in most patients. Specific exercises can be started much earlier. “Around the worlds” can be started almost immediately. See the video on this web site for information and demonstration regarding this exercise. “Yes and No’s” can be started as soon as you are out of your collar. See the video also here.
“Neck sit-ups” should not be done until the complete physical therapy program has been finished. This video is also displayed on this web site.
See also incision care and driving after cervical spine surgery.