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What limitations should I expect after C5/C6 ACDF?

CMCCM Posts: 100
edited 06/11/2012 - 8:26 AM in Back Surgery and Neck Surgery
I am probably going to have ACDF at C5/C6 in about one month. Could those of you who have had a single-level ACDF please tell me what unexpected daily living problems you encountered during your recovery? For example:

1. Did you have to sleep lying flat on your back?
2. Men: Were you able to shave?
3. What did you do about showering? Shampooing your hair?
4. How long can you have the collar off? Can you wear it in the shower?
5. What about preparing meals?
6. I'm sure the surgeon will tell me this, but how soon after surgery did you start exercising? What sort of exercises did you do? Did you have to go to a PT, or were you able to exercises by yourself at home?
7. How soon were you able to drive?
8. For those of you who had C5/C6 done: After you completely healed, did you notice reduced neck mobility?

Anything unexpected problems you can warn me about would be appreciated.



  • I had ACDF c5/6 surgery in March '08. I now have no pain in my neck and I do not notice any reduced neck mobility.
    After the surgery about 4 1/2 hours in OR, I was in the hospital until 4pm the next day. First, had pain pump, and next morning changed to pills for pain relief. I was in some discomfort first 24 hours, about 2am just wanted to stand up, nurse got me up and let me move around a little, then I slept some more until morning.
    When I was home, I used several pillows to prop up and get comfortable in bed and also in my recliner. Was back and forth for first two weeks. Pain not too bad with pain meds. My husband stayed with me for the first few days, he took off work for surgery and the day after then it was the weekend. We put plastic wrap on my bandage, so I could shower. That will make anyone feel some better.
    After two weeks I started feeling better, but had to remember not to overdue. I did help with meals as I could. I have two children, 18 and 14. They are a lot of help too.
    I did not have to wear a collar or do PT. My Ortho said he did not recommend a collar and PT was not necessary in my case.
    I started back to work part time at 6 weeks. I started with 4 hours a day and then extended as I felt I could. I work at a desk/computer and do some retail work, I did have a soft collar I could wear at work if I felt I needed it, it helped me remember no BLT (Bend, Lift, Twist). I was released to drive after 4 weeks, but did not feel very comfortable for some time, I live in an area with lots of traffic and I did not feel I was ready to drive. I did drive some, but only local, quick trips.
    I had some discomfort 5-6 months, especially had to watch how much I did or I suffered the next day. All in all it was harder to slow down so I could recover.
    The only thing I can think of that always bothers me, is the constipation from no eating, soft food only and pain meds, do whatever you can to not let it get you.
    If you think of anymore questions PM me anytime.

  • Hello, Thought I'd give you insight on my surgery experience.

    1. I pretty much had to sleep on my back for about the first week, had to wear hard collar for 4 weeks but was able to take it off during night sleep.

    2. Shaving was impossible for me as the incision had a bandage on it and the area of my drainage tube was sore. I think it ttok about two weeks before I could shave somewhat. Keep in mind, no head bending.

    3. Had waterproof bandage on incision but could only have water touch it, not spray directly on it. To wash, I could only reach below my butt and that was it. To wash hair, I put my back to the water and kept my head straight while bending slightly down with my knees so the shower head was flowing over the back of my head.

    4. Time you have to wear the collar varies upon your doctors instructions, I could not get my hard collar wet.

    5. You want to have someone prepare your meals if possible, or have meals and or ingredients within normal non-bending reach. I lived on canned meals and frozan meals via the microwave for a few weeks. You don't want to have to bend your head down or twist it.

    6. My surgeon did not require any neck excercises at all, he advised when I switched to my soft collar to slowly move my head as was comfortable and the rest would come in time using normal movements. Even after your healed, NEVER snap your head or neck fast.

    7. Was able to drive somewhat after 4 weeks when I switched to my soft collar but even then it was difficult because you still can't turn your head very much without some pain or discomfort. You won't be able to drive in a hard collar unless you plan on running vehicles off the road. LOL.

    8. I have noticed slight mobility change but not as much as I thought I would. I am almost 1-year out from surgery and still have slight pain sometimes, but much better than before the surgery.

    *** I think I spent htree days in the hospital and was released after they removed the drainage tube from my neck. Swallowing was very painful the first week and you'll want to stock up on liquids, soup, puddings ETC. The instant breakfast drinks are excellent for filling you up a little and getting nutrients. I also lost 20 pounds in the first month following surgery. Hope this helped you.
  • Wow, those are exactly the kinds of things I wanted to know. Thanks for sharing your experience and advice.

    Poollady - I would not have thought about constipation being an issue. Maybe I should get some sort of fiber supplement. I think they have pills, or powders you can mix with juice. You mentioned sleeping in a recliner. I've read a few other posts where people mention sleeping in a recliner. I'm tempted to get one.

    Wally2 - I did not think about having to reach down to get something out of the refrigerator. I might get one of those "grabber" things that lets you reach and grab things. Or I guess I could just slowly get down on my knees, grab what I need and then stand up again.

    I will stock up on frozen dinners and soups. I guess looking down at a frying pan isn't going to work. When you mentioned instant breakfast drinks were you talking about a packaged mix, or something like Ensure or Slim-fast? I can't believe you lost 20 pounds!

    I'm wondering how I am going to wash dishes. I've always washed them by hand, but I don't know if that is going to work if I can't bend my neck to look down. Hmm...

    Poollady - I am amazed that you doctor did not require you to wear a neck collar, but wally2's doctor did. I thought wearing he collar was standard. That is a huge difference. I wonder why the difference?

    Neither of you mentioned anything about your hip, so I am guessing you opted for "allograft" instead of "autograft". I'm wondering what my doctor is going to recommend.

    Thanks again!
  • I did forget to mention I too had a constipation problem but it mellowed out after a couple of days. It shouldn't take long since your mainly drinking and not really eating the first week or so.

    I also used the Carnation instant breakfast drinks since the slimfast and others are much more expensive and basically have the same nutrients. By the way, I haven;t regained any of the weight I lost.

    Some surgeons require a collar and some don't. I found that by wearing the collar, both hard and soft, it supports your neck great and gives you confidence in moving around. After surgery, It'll feel like your head is not attached to your neck. It takes some time before your neck muscles catch up with your head.

    My surgeon used cadavor bone and ground up neck disk bone to fuse me. I don't know many at all who still use hip bone.
    Good luck on your surgery and don't worry so much, You'll be fine.

    PS: When you do dishes, use your eyes to look down, not your neck. Bring the dish to eye level, wash, and so on.
    You will be able to use your legs and knees to crouch down to retrieve refrigerator/cabinet items, no problem, just keep your back and neck straight.
  • Wally2 - Thanks again! I haven't thought about that Carnation breakfast mix in ages. That probably would be much cheaper than buying those other drinks.

    I've read that when they use your own bone (from your hip) that the chances of a good fusion are higher. Then again, I've also read there isn't much difference. I'll see what the surgeon says.
  • for starts everyone heals different. you might feel great after surgery or feel like crap. i myself was up and walking within a few hours of surgery. throat was like it was on fire and my neck and shoulders hurt real bad.( shoulders will hurt because of the position your in during surgery) when i got to my room i asked for water and proceeded to drink several large cups. swallowing hurt but pushed through it. first week homw i couldnt lay on back. hard to get up if any of you has had a stiff neck knows how it feels. i slept in recliner sideways. second week iwas able to lie on sides ( cant lay on back due to brace) was able to ROLL out of bed. by the second week i was able to help myself and was able to make small meals. had to drink fluids with food cause things would hang up and gag me.as for showers i was aloud to take collar off cover incision with plastic wrap and tape. being able to let my massage shower hit back and shoulders was heaven. any time you have to take collar off just treat it as if you have it on. if i sat in recliner i would loosen it and just keep head straight.since my first post op visit i could take collar off at 6 weeks which was xmas day. been driving since. been in very little pain. if your having a cadaver bone implanted you can walk right away. i had cadaver bone implanted so ive been walking everywhere since day one. 6 miles on jan 6. since my shoulders and neck hurt from surgery i would get up every day and just do arm rotations too loosen up. as for lifting. still no lifting over 10 lbs till next visit. feb 10. so i get on my total gym and do several exercises on lowest level. which equals about 10-12 lbs of force. but that was at 7 weeks. so dont push it. and i only do enough to loosen up. but i will walk or jump on eliptical every day. just always keep in contact with doc for changes and concerns. and good luck!!!
  • I think we can all agree on recliners, soft foods, driving, calling our docs when things don't seem right,pain levels and recovery time. But remember these are all typical. Sometimes there is the atypical patient where everything doesn't go exactly as planned. So if surgery throws you a curve ball just be ready to catch it.
  • One other food item that might help during your recovery is the Campbells "Soup For One" hand held containers that you just microwave. PS: Love the creamy chicken.
  • 1. I slept in a semi-reclined position (using pillows to prop me up) for the first several days. I was able to lay flat after about a week and moved back to my regular waterbed after 10 days.
    2. Sorry, can't help you there.
    3. I was showering as soon as I got home. The hot water actually felt really good on my neck. Washing my hair wasn't a problem, but I was very careful about drying with a towel.
    4. I never had a collar post-op. My NS wanted me moving, twisting, and rotating my head from day 1 to keep my muscles strong and prevent seizing up and atrophy. I maintained my ROM and never had to have PT.
    5. My mom stayed with me for 10 days and waited on my hand and foot for the first couple days. After about a week I was able to do stuff in the kitchen by myself. (Laundry was another issue)
    6. My surgeon told me to carefully rotate, twist, extend and flex my neck as soon as I got home. This, of course, didn't feel great at first, but I had better pain-free ROM two weeks after surgery than I did since my accident.
    7. I had to drop my mom off at the airport 11 days after the surgery, and I was driving myself back and forth to work two weeks post-op
    8. I'm only 11 weeks post-op, so I'm not completely healed, but I have almost no loss of mobility. I can't quite touch my chin to my chest, but that's about it. Before surgery I couldn't look up at all.

    *I've had a very smooth and successful recovery, so fortunately I can't tell you first hand about unexpected problems. For me, I did everything my doc told me to do, I ate very healthy, took "bone healthy" supplements (see below) and cut back on caffeine. If you smoke, definitely stop. These surgeries can be complete successes and my NS thought I may even be able to be skiing by March, and I will definitely be rafting and horseback riding next summer.

    Keep us posted. Don't be surprised by the pain and muscle spasms post-op. I was miserable the first 1-2 weeks, but my narcotics, muscle relaxers, heat, ice and massage really helped with the pain. Don't forget a bending straw to drink your protein shakes!

    Good Luck!

  • Cliffy, Tonya, Rivertime - Thank you all for the advice and sharing your experiences. I'll have to take care of myself when I get home, so knowing what to expect beforehand will help me prepare. Fortunately, there is a grocery store with a pharmacy within walking distance of my apartment.

    After reading your posts, I'm thinking more seriously about buying a recliner, or a sofa with reclining seats. I've been needing a sofa anyway. The bending straws is a great idea. I'll ask the surgeon about those nutritional supplements.

    I think it is interesting that some surgeons require a collar/brace, and some do not. I would have thought there would be consensus on this point. I guess I should not be too surprised since they have different opinions about PT too. My neurosurgeon was against it, but the neurologist he referred me to was all for it.

    Starting about two weeks ago I began to notice that my right shoulder felt like it was more "forward" than normal, and I felt like I needed to pull it back. At first I thought it was my imagination, but the experience has become more much noticeable. I think this might be another symptom developing.

    Thanks again!
  • Wow! I hope you have someone to at least come check up on you post op. Since you will be caring for yourself, I suggest stocking up on liquid and soft foods that you won't have to cook or prepare for the first several days.... pudding, applesauce, Carnation drinks, protein "meal substitute" drinks, prepared mashed potatoes, soup, etc. That way you can just shuffle over to the refrigerator, take something out and shuffle back to your chair or bed. Get your prescriptions filled ahead of time and have them close at hand with a bottle of water. The first night I was home I woke up in extreme pain and had to wander around the house, looking for my pain meds. Ugh!!! You may want a checklist for meds, too. I was so foggy those first couple days that I didn't know what pills I had taken and when. It could be easy to OD with no one there to monitor.
  • Rivertime, thanks for the advice. I'll be sure to stock up on all those things you mentioned and keep my meds close by.
  • I'm at my 6 week of c5 c6 fusion  but my incision won't heal so he's opening it back up cleaning it out and putting in stables this time but I been wearing this hard collar brace none stop for 6 weeks now he's taking that off of me after doing what he's doing Thursday with cleaning and stables I'm nervous I've not moved my neck aT all is it really going to hurt please someone write me back 
  • Hi CM I have not have this surgery but have had two surgeries and on a waiting list for another in my lumbar.

    On the subject of meds mentioned and keeping track of what you have taken ..... I struggled with this after my first surgery and I tried writing down what I had taken. I now have a pill box, with compartments with morning, lunch,evening and night which I load weekly. This has made a huge difference to me keeping track of my doses. I am on a few so this really helps with the memory lapses and fuzziness caused by these.

    Gold linseed soaked in water is a good daily preperation for preventing or relieving constipation with no added extras. Just stir and drink down for natural relief.

    If you can keep track of these two important things, the rest should follow with the help of sleep and rest with regular but gentle time out of bed or chair to stop the muscles seizing up

    Good luck and keep us posted
    L5/S1 herniation Apr 2013
    nerve root injections Oct 2013
    L5/S1 discectomy Jan 2014
    L5/S1 nerve roo &, facet joint injections & edpidural Jan 2015
    L5/S1 revised discectomy, L4/L5 discectomy & Wallis Inswing Stabilisation L4/L5 May 1st 2015

  • mikebf53mmikebf53 FloridaPosts: 10

    To reply, I am at about 5 months after my ACDF of 5-6.

    1. Did you have to sleep lying flat on your back? For the first two weeks after it was difficult sleeping due to soreness in my neck and incision. The worst was the front where they move the esophagus and make the incision. It wasn't bad enough where I needed the pain meds, but uncomfortable. I would suggest if you can afford it, rent a medical recliner and sleep in that for 2-4 weeks. It makes a difference. 

    2. Men: Were you able to shave? I was able to shave after about a week except where the incision was made. I waited about 2 weeks until slowly shaving that area, until the medical glue that was used to close the incision came off. Usually at 2 weeks, you have a follow up so ask then.

    3. What did you do about showering? Shampooing your hair?  I showered and washed my hair 3 days after surgery. Again, if they use the glue you are fine.

    4. How long can you have the collar off? Can you wear it in the shower? I didn't have to wear a collar. If you are getting the hardware, aka titanium plate, then most don't use a collar.

    5. What about preparing meals? For the first two weeks, since my throat was sore from the moving of parts and the breathing tube, I ate a lot of apple sauce, protein shakes and soft foot. After a few days you are able to move around a lot. I went back to work, (i work from home) about a week later sitting at the computer for short periods of time. It helps time go by.

    6. I'm sure the surgeon will tell me this, but how soon after surgery did you start exercising? What sort of exercises did you do? Did you have to go to a PT, or were you able to exercises by yourself at home? You can start walking that same day and it's encouraged. They also told me I could drive after 2 weeks and begin a swimming regimen. No Michael Phelps workouts, but I began swimming freestyle and breast stroke. After 6 weeks, I was then allowed to use light weights to get strength back and keep on swimming, walking etc. At just over 5 months, I was given the green light to even begin training for a marathon again, but have given up impact exercises.

    7. How soon were you able to drive? 2 weeks

    8. For those of you who had C5/C6 done: After you completely healed, did you notice reduced neck mobility? It can take up to 1 year for bones to fuse. As for healing my neurologist told me it could take the nerves/spinal cord up to 2 years to heal. I had a great deal of compression on my nerves and cord. As for mobility I actually think I have more now. I am in better shape due to more swimming and stretching of my neck. My only issue is bouts with tingling and some strange symptoms that arise, but they told me it would happen. But I can say, in the 5+months I have taken maybe 1 advil for a headache or pain. That is the biggest takeaway.

    Good Luck, but those are my honest answers.
  • Bruce EitmanBruce Eitman Akron, OH, USAPosts: 1,138
    Sassygirl, AJGormit, and mikebf53

    You are all responding to a very old discussion.  CM hasn't logged into Spine-Health since 2014 and nobody had been involved in this discussion since 2009.  While you are welcome to discuss what to expect after ACDF surgery, don't expect much response from the earlier discussion.

    Spine-health Moderator

    Read my story at Bruce - My Story
    ACDF C4-C5-C6-C7, and getting better every day
    It has been a process of healing, learning, exercising, and resting - and figuring out when to do which.

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