Anterior Cervical Disk Fusion Surgery (ACDF) - My Experience
ACDF is Used to Correct Narrowing, Compression, Herniation, and Radiculopathy of the Cervical Spine
An MRI is used to make the final diagnosis for the aforementioned conditions and to confirm the need for surgery. Once under general anesthesia, a small 1-2 inch incision is made in the front of the neck and the damaged disks are carefully removed and replaced by either a neurosurgeon or an orthopedic surgeon; (or in my case, a team consisting of both). Using various types of materials; mine having been a special glue, consisting of finely ground cadaver bone (allograft), that allows the regeneration and formation of new bone that then completes the fusion and makes it stable. Interbody spacers are also used. The vertebrae are also held together with cages and screws, like the model shown below and as you can see in my x-ray images.
I arrived at 5:00 a.m. to the surgery center, prepared for a four-hour procedure. The surgeons worked on me together as a team, with the orthopedic surgeon working on the bones and the neurosurgeon repairing the damaged nerves. I had a combination of narrowing (stenosis), degeneration of the disks in the C 4-5-6 areas, radiculogpthy (compressed nerve roots), and many bone spurs. I had been strongly advised that if I did not opt to proceed with the surgery, there was a strong possibility that I could become paralyzed, if ever in a serious collision or accident. The choice to proceed was a no-brainer and I was told that I'd be able to return to most, if not all of my activities in 6-12 months (marathon running, backpacking, yoga).
My Recovery Experience
Post-op day #1-2
I only had to stay in the hospital for one night until my vital signs were stable, I was able to walk up and down the hall with and without assistance, and could manage in the bathroom. Day #2 was very difficult and the pain medication they prescribed was essentially worthless. I felt as if there was a golf ball, inside of a tennis ball, inside of a baseball, inside of a softball, inside of a basketball, all stuffed in my throat.
Swallowing (dysphagia) was a total nightmare from the time I woke up from surgery. I lived on fruit pops, ginger ale, water, smoothies, shakes, soup, tea, and coffee, for several days and even that was all hard to swallow. A dear friend juiced up a bunch of organic carrots for a natural laxative "aka poop juice" as she called it, since general anesthesia is known to put a halt to the gastrointestinal system; and in my case, it did for two weeks!
Ice packs and walks were wonderful for short term relief to take the edge off. The surgical site and spinal bones felt only somewhat sore, so it was just mainly my trachea that caused most of the pain and difficulty swallowing.
Post-op Day #4
I was still having much difficulty getting solids down due to my swollen trachea and esophagus, and I was honestly unsure which one was the culprit; maybe both? I made some turkey noodle soup to step up my game a bit.
My Blinged Out Neck Brace Ready For ActionClick thumbnail to view full-size
Post-op Day #5
By day #5, I was on my own as my husband had to go back to work. The pain had not subsided much and the lumpy, painful throat was the worst part of the whole ordeal as it felt like razor blades. I felt like I was in a brain fog too. I guess going from taking no medications most of my life to 2-3 different medications in one week will have that effect. I started spacing the pain medication out for longer intervals and the neck brace seemed to exacerbate the pain. I was advised to wear the brace during all waking hours and that I could have it off for sleeping.
Post-op day #6
The fun kept coming. I woke up abruptly at 11:30 that night with a choking feeling, as if my tongue was swollen. I also had no sense of taste. It took me awhile to realize that I was breathing fine and not having an allergic reaction to something, so I finally settled back down and went back to sleep. Who knows what that was all about?
By this point, I was getting around great, my appetite was back to normal, and I had a great visit with with a friend for a few hours, which included a nice, big latte' from the local coffee shop. It's amazing how much a visit and a treat can lift one's spirits.
I got my first look at my incision with the steri-strips off that morning and it didn't look so good. My nursing expertise told me right away that it looked infected, so I called my surgeon's office and they called back with a prescription for antibiotics just to be on the safe side.
Post-op Day #7
I got out and walked 2 miles today. This was a huge victory for just being one week out.
Post-op Day #8
Today I started really thinking about my marathon running and that maybe one day soon, I could train hard again! I was really feeling good, could swallow without pain, and felt that healing was finally taking place.
Progress During Week #2Click thumbnail to view full-size
Post-op day #12
It was so pretty outside for a late November day. I'd been taking daily walks ever since the day after surgery despite how terrible I felt a few of those days. Not being able to drive was a pain, although I knew that would not be a good idea since I couldn't move my neck yet, and technically still had to wear the brace. I was sitting there today looking at my crappy fingernails and being that there is a nail studio within a mile and a half walk from my house, I hoofed it there and back. There's nothing like a good manicure to make a girl feel happy!
After my nail appointment, I met one of my running friends for a brisk seven-mile walk. I wasn't even even two weeks post-op and I felt like I could've done more!
Post op day #18
I went back to yoga the last two days! ( hitched a ride from another fellow yogi as I'm still not allowed to drive. I took it very easy, wore my brace, modified every move, and didn't do anything with an inversion or twist. It felt so good to get those bones loosened up.
Post-op day #20
I had my first surgical post-op visit at the three-week mark, which should have been after two weeks, but my surgeon cancelled due to a personal emergency. I felt like this was way too long to wait for a post-op visit, so I just listened to my body, pushed where I felt I could, and rested afterwards. I was not going to waste a second of what could've been a whole week of being allowed to start adding my activities back in!
I also went back to my nursing "desk job" at the end of the second week before having my follow-up appointment, which we determined over the phone. I had to have a friend or my husband drive me since I was not yet cleared. I got a little achy towards the end of the shift from sitting so long, but it went better than I'd anticipated.
While at the surgeon's office, I got scolded for asking if I could go back to yoga (not admitting that I had been to two classes already) and since he "threw me a bone" allowing me to go back to work at two weeks, he said absolutely no yoga for two months! Not even modified, easy yoga. He said if I mess up the hardware, he will go in from the back and put in rods, and then I really won't be happy with the recovery. I got the green light to drive though, so small victory there.
I set up physical therapy visits that would start around the 30-day post-op mark. I was getting tired of holding my neck stiff and still, so I actually looked forward to the therapy. The surgeon said that I could go walking as much as I wanted, but was still not allowed to use the stationary bike. I really didn't mean to be a difficult patient, but I knew this was going to be the hardest part of my recovery because I am a very active woman.
The Success of Anterior Cervical Disk Fusion Surgery
So far, all of my hip pain is gone and has been since the surgery. I'm hoping that the removal of the bone spurs that were compressing certain nerves cured that too. My neck feels less constricted and less painful in the areas where I had suffered for nearly 20 years. My surgeon said it was very tight from the stenosis, which they fixed with the disk removal/replacement and cages. Once the post-operative discomfort subsided, I did some physical therapy sessions to start moving my neck, I wish I hadn't waited so long to have this surgery. I let fear rule over common sense. My quality of life has vastly improved, as has my range of motion. I can now look over my shoulder when I'm driving, which I hadn't been able to do for years. It is so nice to not have to be constantly going for alternative therapy visits (chiropractor, acupuncture), or taking muscle relaxers and ibuprofen, which I generally avoided since I do not like taking medication to begin with.
Post-operative Scar at Four Months and Two YearsClick thumbnail to view full-size
I'd love to hear about your Anterior Cervical Disk Fusion experience.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
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© 2018 Debra Roberts