1. A Patient’s Guide to
Anterior Cervical Discectomy with Fusion (ACDF)
25 Thurber Boulevard, Unit 6
Smithfield, RI 02917
Tel: (401) 404-2975
Fax: (401) 404-2976
www.bsnidoctors.com

2. Introduction Frequently Asked Questions
What is a cervical disc herniation? How long will my surgery last? Between one
A cervical disc herniation occurs when a portion of the cushion that sits and two hours, depending on the number of
between 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 the
Since 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 weeks
This is also known as a cervical radiculopathy. Medium work (lifting up to 50 lbs.) 4-6 weeks
Strenuous work (lifting >50 lbs.) 3-4 months
What are my options?
The four standard options to consider include medication, physical How active can I be? Activity is encouraged, especially walking. You may
therapy, 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 with
How 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 to
weakness or other neurological symptoms, or have exhausted all other
chew are encouraged. Difficulty swallowing is expected and will subside
options.
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.

3. The Procedure
Surgery for anterior cervical fusion is
performed with the patient lying flat on The images below show the placement of the metal plate and screws
his/her back. A small incision is made in from a lateral (side) view and anterior (front) view.
the anterior side (front) of the neck, and
the muscles of the neck are moved to one
side to expose the disc.
The disc is then removed, after which a drill is used to remove any bone
spurs.
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.

4. What to Expect After Surgery MEDICATIONS LIST
Hoarse 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 surgery
manipulation. 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 days
roots 2-3 days following surgery. It will gradually improve and slowly prior to an injection or to surgery
subside 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 may
after 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 neurologic
findings that were not present at the time of your hospital Advil Duradyne Nabumeton
discharge. 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 Relafen
How do I get refills of my prescription? Call our prescription hotline
Celebrex Ginko Bilboa Reopro
during business hours (9am–4pm) at (401) 404-2975 x152. Ginseng
Cephalgesics Robaxisal
When will I start physical therapy? This will be discussed at your first Clinoril Ibuprofen Ticlid
post-operative appointment. CLOPIDOGREL- Indomethacin Trental
BISULFATE Indocin Vanquish
When can I shower? Two days after surgery with the original waterproof Coricidin Integrilin Vitamin E
dressing. You must replace the dressing after every shower with a clean, COUMADIN Ketoprofen Voltaren
dry dressing. Daypro Lodine WARFARIN
Diclofenac Meloxicam
What about taking anti-inflammatory medications after surgery? Anti- Midol Any herbal supplements or
Diflunisal
inflammatory medications should NOT be taken until 6 months Doan’s Mobic non-FDA approved drugs
AFTER your surgical procedure. Dristan Motrin
*If you are taking any of the medication HIGHLIGHTED, you MUST
consult your physician prior to discontinuing your prescription*