Neck Diskectomy and Fusion

Cervical Disk Herniation

Cervical Disk Herniation

Neck Diskectomy and Fusion

Also known as Anterior Cervical Disectomy and Fusion

 

Frequently Asked Questions

  1. How long of a hospital stay can I expect?

For a one or two level procedure, most patients go home by the next day. Some patients are fine to be discharged on the day of the surgery.  If you are having three or more levels operated on, you will be in the hospital for approximately 2 days. If your pain level is tolerable and you are doing well medically, you can expect to be discharged.

  1. Will I need a neck collar or brace?

For a one or two level Neck Diskectomy and Fusion, you will leave the hospital with a soft cervical collar. You may take this off when you wish. We encourage you to wear it for the first week, especially when outside the home. For larger surgeries involving 3 or more levels, you probably will be placed into a more rigid cervical collar. Dr. Shim will discuss with you how long you will have to wear this collar after surgery.

  1. If my doctor orders a collar, do I wear it when I drive?

No, It is against the law to drive a motor vehicle with a cervical collar on. You will need to wait until the collar is removed before you may drive.

  1. What is the approximate time it will take me to recuperate?

While everyone’s pain tolerances and conditions differ, most recover from this type of surgery with a 4 to 6 week time period.

  1. How long before I can return to work?

This depends on the type of work you perform and the duties involved. Dr. Shim will discuss this with you during your first post-operative follow-up visit. In general, most patients can return to a sit down type job with no lifting required within 2-3 weeks after surgery. Those patients who have heavier duty occupations requiring lifting, pushing, pulling, and overhead activity can expect to be out 4- 6 weeks.

  1. How long before I can drive?

For a one or two level Neck Fusion and Diskectomy, most patients can safely return to driving within 2 – 3 weeks after surgery. Those who have 3 or more levels operated on and are placed in a rigid collar, may not drive for up to 6 –8 weeks.

  1. How should I take care of my surgical incision?

Your incision is closed with dissolving sutures under the skin. The skin is held together with steri-strips until the wound is healed. We also utilize an excellent dressing called Silverlon.  Please do not remove the dressing, as we will remove the dressing and inspect the wound on the first post-op visit.  You can shower with the dressing, just pat it dry.  After inspection of the wound, further instructions will be given.  In most situations, the wound is almost healed by the post-op visit.

  1. When can I walk?

As a normal part of the post-operative period, we encourage you to get up and walk the morning after your surgery. You may walk as much as you can tolerate.

  1. Will I require the use of a walking aid?

Some patients do use an assistive device such as a cane or walker after surgery. This is determined on an individual basis.

  1. Will I need therapy after surgery?

At the time of your first post-operative visit in the office with Dr. Shim, you will be instructed to begin gentle range of motion exercises for your neck. Most patients are able to do their own therapy at home and don’t require a formal therapy program.

  1. How long will my sutures stay in place?

Your Neck Diskectomy and Fusion  incision was closed with dissolving sutures. Therefore, there is nothing that has to be removed.

  1. Will I be able to have sexual relations after surgery?

Yes, you may resume sexual activities as soon as you feel up to it. This may be a few days or even a week after you come home from the hospital. You should avoid positions which cause increased neck discomfort.

  1. How long before I can fly in a plane?

Most patients are free to travel after their initial post-operative visit 10 –14 days after surgery. Patients who may have been experiencing any problems during this time may be encourage to wait a little longer before traveling. Keep in mind, you will not be able to carry any luggage greater than approximately 10 –15 pounds for the first 4 weeks after surgery.

  1. How long before I can take a bath at home?

You may take a bath upon your return home, but you should avoid total immersion of your head and neck.  As we are now using the silverlon dressing, you may get it wet, but just pat it dry.  Most patients can safely resume a normal bath 3 weeks after surgery.

  1. How long before I can shower at home?

Because we are using the Silverlon dressing, you may shower with the dressing on.  Just pat it dry.  Remember, do not remove the dressing.  It will be done at the office.

  1. Do I need to be on a stool softener?

A stool softener will be ordered for you while in the hospital. You may discontinue this after your first bowel movement or at your discretion.

  1. Is it alright to sleep on a waterbed?

We encourage you to sleep on at least a semi-firm surface following surgery. Some water mattresses may be too soft immediately after surgery.

  1. Will I be able to walk up stairs?

Most patients will be able to walk up stairs after surgery. You should limit the amount of times you go up and down the stairs during your first few days home. We encourage you to use a handrail if one is available.

  1. Will I be able to go swimming?

Yes, in approximately 3 weeks after surgery.

  1. When will my pain improve?

Everyone’s pain tolerances and conditions do vary. In general, many patients experience some relief of their arm symptoms immediately after surgery. It is not uncommon to have neck soreness, stiffness, and incision discomfort for several weeks beyond surgery. For some patients, the pain level may decline slowly over weeks or even months after surgery.

  1. Why does everything hurt 2 or 3 days after surgery when I felt so good immediately afterwards?

Several reasons for this. First, you were given medications to help relax you and your pain during the surgery along with the anesthesia. This combination of medications may stay in your system for a day or two after surgery. Secondly, as you start feeling better, most patients become a bit more active, this can lead to increased discomfort initially.

  1. Why is my throat sore?

A sore throat can result from anesthesia in some cases. You received an endo-tracheal intubation (“tube”) into you throat to help you breath during the procedure. This may have irritated the lining of your throat. Also, for patients who undergo surgery on the lower aspect of your neck, you can develop irritation of a nearby nerve. This soreness and even some difficulty swallowing tends to resolve within a few weeks after surgery.

  1. How long does a fusion take?

In general, a healthy, non-smoking adult with no significant other medical problems can expect to see evidence of fusion in 4 to 6 months after surgery. Patients who do smoke or are diabetic tend to take longer to fuse. In some cases, it may take a year to fuse.

  1. When do I call the doctor?

If you experience any fevers over 101.5 degrees, any wound drainage, swelling or redness around your surgical incision, increasing pain, tingling or numbness that you did not have before surgery, difficulty swallowing, difficulty walking, severe headaches or weakness, call your doctor.

  1. How will I know what is too heavy to lift?

You can lift up to 5 lbs after surgery until your first post-operative visit. After 10 – 14 days, Dr. Shim will allow you to lift up to 15 lbs.

Comments (28)

    • David,

      I am understanding your comment. I am sure your surgeon had the best intent with your surgery. I am glad you have only intermittent symptoms at this point, as that usually indicates you are already experience improvement of your symptoms. But, if you have concerns, please discuss this with your surgeon. In the worst case scenario, you may have residual nerve irritation despite a surgical intervention.

  1. Good evening Dr Shim,
    I has disc replacement surgery in 2010 with Mr Reilly at the Spire hospital in Hull England in my neck C5 with a replacement titanium disc ,I have congenital fusion of my C3/4 discs. However I am experiencing further pain in the disc below my replacement causing neck ache, throbbing and the need to lay down and rest. I am seeking advice on what it maybe?
    Kind regards
    Lesley Nowell

    • Mr. Nowell,

      By the sounds of it, you had a successful disk replacement until recently. Have you followed up with your surgeon? If not, you should consider doing so. In addition, consider at least getting x-rays to make sure the disc has maintained its position. Without knowing the specifics of your circumstance, concerns can be as simple as a neck sprain, to more significant such as a late collapse of the bones around your artificial disk. Of course, there is always the concern that you developed a new, unrelated disk problem at another level. Please see you surgeon to make sure these possibilities have been explored.

      Good Luck to you!

  2. Hello Dr Shim,

    I am 2 weeks post surgery and started having a new pain from my neck down into my back. Additionally occassionally I have tingling in both arms and legs which I didn’t have prior to surgery or immediately after surgery.

    My Dr keeps saying oh you will feel all sorts of things after surgery and not to worry but the pain in my neck and back is pretty painful. How do I know when it is an issue and not just postoperative pain?

    • Matt,

      With out knowing the specifics, these complaints do not sound too unusual. Initially after neck surgery, sometimes tissues get stretched causing a neck discomfort to the back of head, neck and into the upper back. Also, if the nerve was under considerable compression, it is not unusual to have a rebound effect with occasional arm and leg sensations. These feelings should improve with time, and I understand your surgeon’s assurances. If the symptoms persist, I am sure your surgeon will do followup studies to make sure the surgical objectives have been accomplished. Good luck, I wish you a successful recovery!

  3. Should a patient remove their neck brace whenever they want after surgery? I know a patient that is removing their brace and looking down continuously to view their smartphone

    • Kipp,

      Thanks for the question. It depends on your surgeon and the type of surgery. If the patient has had successful ACDF surgery with secure placement of a plate, and the surgeon is confident about the placement of the graft and plates, usually, the brace is more for comfort, and not for added stability. On the other hand, if the surgery is for multiple levels, and there is concern for poor quality bone, or if there is concern for adjacent level problems or plate and screw fixation, the surgeon may not want the patient to remove the brace. If you have concerns, you should reach out the surgeon to understand the protocol for the particular patient and surgery.

  4. Dr.Shim,
    I am 7 weeks out from an anterior cervical discectomy/ fusion C4-C7. I am still having problems swallowing. I do have increased pain/discomfort in the back of my head. I have been allowed to remove my brace and I can now lift up to 15 lbs. My x-rays taken last week show that the screw and plate at C7 has pulled out about a centimeter. Do you think this is causing the problems that I described above.
    When I woke up from the surgery, I had no pain and took no pain medication. I did have the swallowing problem. To this day, I have not taken pain medication so I’m sure that this pain behind my neck is new.
    Thank you

    • Daler72,

      I am only going by what you have described to me. I would discuss your situation with your surgeon again. I have some concerns about your comment that the screw and plate has pulled out by a centimeter. Are you sure that is what has happened? Sounds like you have done well initially. I would discuss your situation with your surgeon again to make sure you have the information correct.

      Good luck to you.

  5. Hi I have a few questions and concerns…My husband had a fusion at C5/6 and a replacement at C7 he is only about 1 1/2 weeks post op….He of course decided to drive within a week of being home right after that he ended up in a sneezing fit with serious neck jerks before both of these occured he seemed to be doing a big better on pain and now it is at a 9 level even taking his Hydrocodone what his surgeon put him on and only left him on it for 6 days…He did not have any type of collar on nor sent home with one I am worried after reading some things and knowing myself I have chiari and have had decompression of the brain and 1/2 my C1 vertebrate removed that this does not sound right……can you help me here?

    • Tiffany,

      I have to let you know that I am just giving general advice. You must really talk to the surgeon to get the physician’s recommendation. Sounds like he is still in the recent posta-op phase. If there is concerns for increased pains, please contact the physician. You might also ask if a new x-ray may be in order. As far as a brace is concerned, many surgeons no longer use a brace, except for the patients comfort, unless there is concerns for excess movement after the operation.
      Finally, as far as lifting restrictions, once successfully fused, or recovered from replacement, most people can return to all activities. In general, however, I would recommend considering a profession that avoids excessive lifting or overhead reaching and lifting. In this economy, that may not be a reality. I understand a person needs to work to provide. Please ask the surgeon the questions asked here, as his surgeon is the best person to answer specific questions.

  6. Hi, I have problems at c5/6 and c7/8. My arm constantly has pins and needles and my hand becomes so numb that some times I have to stop writing in my job as a lawyer. I have attended with my local doctor who has indicated that he has two patients who have had the fusion operations and their symptoms became actually worse post operation. He has advised me to think carefully about going to operation and I would be grateful for your comments on this.
    Christine

    • Christine,

      I would agree that everyone should think carefully about surgery. But, the decision is based on all the information, and a good review of the diagnostic studies along with a good neuro muscular exam. The comment that two patients worsened post surgery needs to placed in the context of how many other patients have had successful surgery. Also, the circumstances of each patient can be different. It also sounds as if the physician advising you is probably not the surgeon. If you physician has trouble with the outcomes of a particular surgeon, they should say so. But, in general, in the properly selected patient population, neck disectomy and fusion surgery has a good outcome ratio. Please get advice from a well respected spine surgeon in your geographic area. As an attorney, I am sure you have the capability to research that area well. Also, as an attorney, you know that there will always be pros and cons to every situation, and every opinion. Please weigh both carefully before you make a decision, or favor an opinion.

  7. I fractured my c3 like 6 1/2 months ago .. I had to wear a neck brace for about 4 1/2 to 5 months and for this last month I’ve had it off and seem to be doing fine. My schedule is always so busy so it’s hard to make time for doctor appointments so my question is.. Would it be okay for me to start working out again? I’m not lifting any weights. I’m just doing the T25 workout video?

    • Tory,

      That is a question you should ask of your spine physician. Unfortunately, In this type of forum, I cannot give individualized recommendations. But, let me put in a way everyone can understand. You are fortunate to be doing well considering the nature of your problem. Sounds like it could have been life altering. Please get appropriate followup and advise by someone who knows your situation well. At this point, you do not want to jepardize your excellent recovery by doing things that may not be beneficial.

  8. I was having deep pain in my shoulder and burning pain in my elbows (mainly left side). After an MRI of my shoulder and neck they saw that C5/C6 was herniated. I went through a fusion surgery. I am a little over 2 weeks out and recovery has been going well except for the headaches. They informed me that my pain would take months to go away and I am okay with that. My main concern is the pain in my elbow. It is mainly one elbow (same side as my shoulder pain). The outside of it burns at times and it hurts to rest it on a chair armrest. Is this pain normal from a herniated disc? My worry is I have read that most arm pain resolves itself pretty quickly if not immediately after surgery. I am fearing it may be tendonitis. Any thoughts?

    • Jason, I cannot give specific advice, but only talk in generalities. Most patients have good resolution of symptoms, although residual numbness and tingling is common for some time. Just because you have a disk herniation does not mean you cannot also have a separate elbow condition. It sounds like you are improving, but you should get medical attention to your elbow if concerned.

  9. I had a c6-c7 fusion almost 3 months ago now. I am still having a lot of neck pain and some arm pain still. It hurts to move my head side to side and back and forth. My pain level is around a 5 most times. I am sure I didn’t follow to the T like I should have. Been lifting more then I should and do more in general. Just not sure if I should be worried or not. Or if this is part of the course. Need help

    • Diana,

      I must preface my comments by first suggesting you speak to your surgeon about the specifics of your surgery. Also, I am sure your physician has x-rayed the neck since the surgery to make sure the fusion construct looks appropriate. It is not unusual to have some pain and discomfort for the first several months after surgery. Occasionally, surgery may cause an effect on levels next to the level of fusion causing development of narrowing of the space for the nerves at those levels. Also, if there is an arthritic condition at other levels of the neck, the fusion can cause increased focus on the other arthritic levels. At three months, if the pain is persistent, but the fusion is incorporating well, I would sometimes start PT, start NSAIDS or do further workup with additional MRI’s, etc. Please discuss with your surgeon. As in all surgery, the surgeon’s intent is always to do the best for the patient. Please share your concerns.

  10. Hello I need advise in a few weeks I am having a C1 to C4 bridge placed for hemi vertebrae and right side total collapse along with a C4 to T4 fusion all at once I am very nervous as I cant find anyone whos had such a 14 to16 level fusion / rebuild,can you tell me how long of a surgery this maybe,what the vrecovery room and hospital stay (pain wise) will be like and how long I will be down at home..sorry for the questions very nervous before surgery,thanks

    • Josh,

      Your situation does sound significant. I cannot give you specific advice, as I am not your physician. But, by your description, you have a congenital condition that warrants a significant operation. I am sure you must be seeing a well recognized surgeon with lots of experience as few surgeons would tackle such a difficult sounding operation. I am a bit concerned about your understanding of your surgery. A C4-T4 fusion is not 14-16 levels, but 7 levels. I do not know what you mean by a C1-C4 bridge. But, in general, you can expect up to a 4-6 hour operation or more if both an anterior and posterior approach is used. If you have concerns, please get a second opinion. Confident surgeons do not mind that, as long as the second opinion is done on a timely basis and does not change the plans of surgery. These large surgeries take a significant amount of planning, and reserving of equipment, operating room, and time. Please let your surgeon know you are considering a second opinion so the surgeon can plan accordingly. Patients do not realize this, but rescheduling a large operation like this takes lots of time by many staff members, both at the doctors office and the hospital. At the end, you must be confident about your decision, and your surgeon. Good Luck!

  11. Thank you for your time,Yes it was hard to find a surgeon ,7 hospital spinal groups turned me down ,and finally 3 hospitals got together (university and decided to use 2 set of titanium(I believe) cages…placed around the spine with interior work with an expected 24 hour surgery and 4 to 5 transfusions,that was to much for me to take as they al(the chiefs of ortho at UC and others admitted they had never done the surgery before ,the surgeon I’m seeing now is the second opinion,he is a great guy and yes is very confident and nice,the bridge is a (congenital) collapse where C1 is touching C5 on the right side because of the hemovertebraes at c2,c3,c4,he has to bridge /prop c1 and c5 apart with a piece of bone. and then fuse C4,C5,C6,C7,T1,T2,T3,T4,AND MAYBE T5 TOGETHER.he does specialize in deformities of the spine his name is doctor Stanley here in Denver..(I have looked for a few years and besides the first group who couldn’t even say if I would wake up,he has been confident threw out,and its much les evasive…I geuss I didn’t explain well above..apologoes,do you think my recovery will be more like 3 months or 3 weeks,he has said to expect 7 to 10 days in the hospital post op…thanks for your time.Josh

    • Josh,

      All I can say is make sure you have a good relationship with your surgeon, and you are made aware of all the ramifications. Sounds like you need this surgery to become productive, and participatory in life, and I agree those are very important goals. I cannot estimate your recovery time as it sounds like you are going into somewhat uncharted waters. Recovery does depend on the nature of surgery, and the nature of your physical condition prior to surgery. As I said, you need to discuss these questions with your surgeon. I have not been involved in deformity surgery for more than 15 years, and will not be able to give you any more information than I have already given. But, I wish you a positive and rapid recovery!

  12. tHANK YOU, ALL OF YOUR INFO WAS VERY HELPFUL TO ME,I AM SCHEDULED IN 9 DAYS FOR SURGERY AND THEY ARE USING A FRONT AND REAR APROACH AT THE SAME TIME,FRONT TO PUT PLATES OVER C4,C5,C6,AND C7…THE REAR TO PLACE SCREWS AND RODS FROM C4 TO T4…I HAVE A BETTER UNDERSTAMNDING NOW OF WHAT TO EXPECT AND HOW IT WILL BE DONE…THANK YOU AGAIN FOR YOUR RESPONSES IT GAVE ME MUCH NEEDED INFO TO REQUEST THAT LED TO A BETTER PEACE OF MIND IN SURGERY…THANK YOU AGAIN…

    • Josh, good luck to you. I am sure you have researched your options, your surgeon, and the procedure. Now try to prepare mentally with a positive attitude. It does help!

  13. Hi I had ACDF last Thursday so this is day 5 and today I feel terrible , my neck feels like it’s being squeezed really tight & I can barely talk and have the worst head ache ever . Is this normal ??

    • Ange, I hope you spoke to your Surgeon. The first week can be rough, especially with issues such as swallowing chunking food, incision pain, difficulty talking and sometimes, paradoxic increased arm pain for a short duration. If you have any concerns such as fevers, sweats, and new weaknesses, you should contact your physician right away. Otherwise, hang in there. The vast majority of patients who have ACDF improve over time. Headaches can effect some people as well. If it is a severe headache, please get it checked.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>