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ACDF is a complex surgery. Not all patients get complete pain relief with this procedure. As with any surgery, you should expect some pain afterward. If the pain continues or becomes unbearable, talk to your doctor about treatments that can help control your pain.
What happens after surgery?
After ACDF, patients usually wear a special neck brace for several months. These neck braces are often bulky and restrictive. However, the bone graft needs time to heal in order for the fusion to succeed. This requires the neck to be held still.
Recently, surgeons have begun using metal hardware, called instrumentation, to "lock" the bones in place. This hardware includes metal plates and screws that are fastened to the neck bones. They hold the neck bones still so the graft can heal, replacing the need for a rigid neck brace.
Patients usually stay in the hospital after surgery for several days. They can get out of bed as soon as they feel up to it. The drainage tube is removed from the neck after one or two days. Patients are watched carefully when they begin eating to make sure they don't have problems swallowing. They usually drink liquids at first, and if they are not having problems, they can start eating solid food.
A physical therapist will schedule daily sessions to help patients learn safe ways to move, dress, and do activities without straining the neck.
Patients are able to return home when their medical condition is stable. However, they are usually required to keep their activities to a minimum in order to give the graft time to heal. Outpatient physical therapy is usually started four to six weeks after the date of surgery.
What should I expect as I recover?
Rehabilitation after ACDF can be a slow process. You will probably need to attend therapy sessions for two to three months, and you should expect full recovery to take up to eight months.
Many doctors prescribe outpatient physical therapy beginning a minimum of four weeks after surgery. At first, treatments are used to help control pain and inflammation. Ice and electrical stimulation treatments are commonly used to help with these goals. Your therapist may also use massage and other hands-on treatments to ease muscle spasm and pain.
Active treatments are slowly added. These include exercises for improving heart and lung function. Walking and stationary cycling are ideal cardiovascular exercises. Therapists also teach specific exercises to help tone and control the muscles that stabilize the neck and upper back.
Your therapist also works with you on how to move and do activities. This form of treatment, called body mechanics, is used to help you develop new movement habits. This training helps you keep your neck in safe positions as you go about your work and daily activities. At first, this may be as simple as helping you learn how to move safely and easily in and out of bed, how to get dressed an undressed, and how to do some of your routine activities. Then you'll learn how to keep your neck safe while you lift and carry items and as you begin to do other heavier activities.
As your condition improves, your therapist will begin tailoring your program to help prepare you to go back to work. Some patients are not able to go back to a previous job that requires heavy and strenuous tasks. Your therapist may suggest changes in job tasks that enable you to go back to your previous job or to do alternate forms of work. You'll learn to do these tasks in new ways that keep your neck safe and free of strain.
Before your therapy sessions end, your therapist will teach you ways to avoid future problems.