A Patient’s Guide toAnterior Cervical Discectomy with Fusion (ACDF) 25 Thurber Boulevard, Unit 6 Smithfield, RI 02917 Tel: (401) 404-2975 Fax: (401) 404-2976 www.bsnidoctors.com
Introduction Frequently Asked QuestionsWhat is a cervical disc herniation? How long will my surgery last? Between oneA cervical disc herniation occurs when a portion of the cushion that sits and two hours, depending on the number ofbetween two bones in your spine has moved and is irritating a nerve. levels. How long will I be in the hospital? This is typically a same-day surgery or a one-night stay. Where does the bone for the bone graft come from? The bone typically comes from a donor (cadaver), although other options are available. How much neck mobility will I lose with an ACDF? This will depend on how many levels are fused along with your range of motion before surgery. When can I drive?* This varies greatly from patient to patient, but usually short drives are fine after 7-10 days. This depends upon your neck mobility and use of narcotics.Why does it cause arm pain? When can I go back to work? This will depend on the individual and theSince your nerves run from your neck to your arms, any pressure on the type of work being performed.nerves in your neck can cause arm, shoulder, and/or hand symptoms. Light/sedentary work (lifting <25 lbs.) 2-3 weeksThis is also known as a cervical radiculopathy. Medium work (lifting up to 50 lbs.) 4-6 weeks Strenuous work (lifting >50 lbs.) 3-4 monthsWhat are my options?The four standard options to consider include medication, physical How active can I be? Activity is encouraged, especially walking. You maytherapy, epidural steroid injections, and surgery. begin to exercise as early as one to two weeks in the post-operative period. Gentle upper extremity exercises are helpful. Avoid activities withHow do I choose? twisting and/or bending of the neck.Surgery is often advised for those patients who present with concerning What can I eat after surgery? Soft foods or any foods that are easy toweakness or other neurological symptoms, or have exhausted all other chew are encouraged. Difficulty swallowing is expected and will subsideoptions. with time. Can I get an MRI after an ACDF? Yes, the instrumentation used for an ACDF is MRI-compatible. *Narcotic usage while driving is not recommended.
The ProcedureSurgery for anterior cervical fusion isperformed with the patient lying flat on The images below show the placement of the metal plate and screwshis/her back. A small incision is made in from a lateral (side) view and anterior (front) view.the anterior side (front) of the neck, andthe muscles of the neck are moved to oneside to expose the disc.The disc is then removed, after which a drill is used to remove any bonespurs. The peak cage is then placed within the disc space. It will then be reinforced with a metal plate and screws. Together these will support the cervical spine while fusion takes place. Following placement of the bone, plates, and screws, the incision is closed using dissolvable suture material.
What to Expect After Surgery MEDICATIONS LISTHoarse throat/throat discomfort/difficulty swallowing: This is due to The following medications and supplements contain aspirin or anti-the breathing tube placement during surgery as well as the surgical inflammatory agents, which increase the risk of bleeding during surgerymanipulation. This will gradually improve with time. or injections.Increased arm pain: This is due to inflammation/swelling of the nerve These medications and supplements should NOT be taken up to 14 daysroots 2-3 days following surgery. It will gradually improve and slowly prior to an injection or to surgerysubside over the following week. In severe cases, oral steroids are used.Pain between shoulder blades: This is the most common discomfort Should you need pain relief medication, Tylenol is acceptable. You mayafter surgery and can usually last up to 3 weeks. As the fusion progresses, discuss other medication options with your physician or nurse if necessary.this pain should subside. Please note that this is not an inclusive list. If you have any concerns about your current medications, please consult your doctor, nurse, or pharmacist.You should call the office if you develop any neurologicfindings that were not present at the time of your hospital Advil Duradyne Nabumetondischarge. Examples include: AGGRASTAT Ecotrin Naprosyn Sudden or slow onset of weakness in the upper/lower AGGRENOX EFFIENT Naproxen Aleve Enbrel NSAIDS extremities Equagesic Norgesic Alka-seltzer Loss of control over your bowel/bladder Anacin Etodolac Oxaprozin Elevated temperature (greater than 101 degrees) Anaprox Excedrin Piroxicam Excessive redness/swelling of the incision Ansaid Feldene PLAVIX Drainage/oozing from the incision site ASPIRIN Fiorinal PLETAL Bufferin 4 Way Cold Tabs PRADAXA Cataflex Garlic Tablets RelafenHow do I get refills of my prescription? Call our prescription hotline Celebrex Ginko Bilboa Reoproduring business hours (9am–4pm) at (401) 404-2975 x152. Ginseng Cephalgesics RobaxisalWhen will I start physical therapy? This will be discussed at your first Clinoril Ibuprofen Ticlidpost-operative appointment. CLOPIDOGREL- Indomethacin Trental BISULFATE Indocin VanquishWhen can I shower? Two days after surgery with the original waterproof Coricidin Integrilin Vitamin Edressing. You must replace the dressing after every shower with a clean, COUMADIN Ketoprofen Voltarendry dressing. Daypro Lodine WARFARIN Diclofenac MeloxicamWhat about taking anti-inflammatory medications after surgery? Anti- Midol Any herbal supplements or Diflunisalinflammatory medications should NOT be taken until 6 months Doan’s Mobic non-FDA approved drugsAFTER your surgical procedure. Dristan Motrin *If you are taking any of the medication HIGHLIGHTED, you MUST consult your physician prior to discontinuing your prescription*