Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

ACDF Surgery at C4/5/6

WonderboytwiceWWonderboytwice Posts: 149
edited 06/11/2012 - 8:46 AM in Neck Pain: Cervical
:))( I am due to have the above surgery on 18th September and must admit to being rather worried about the problems with voice box and swallowing as I already have problems swallowing due to muscular spasms! How long does the surgery take and when will I be able to drive again? My Surgeon has said he is going to use titanium cages. Has anyone had the operation with these being used? I had in December 2008 a very lengthy PLIF with the same Surgeon so I have every confidence in him. I wish all of you who have recently been operated on a very safe and speedy recovery. I love reading articles on this forum.


  • I've had a 3-lvl ACDF and in my case, I had very little swallowing problems post-op and had a raspy voice for about two months. Singing was a definite no-no when in the car with my hubby.

    I'm exactly opposite of you in the sense that I had an ACDF 1yr 3mo before I had a TLIF at L4/5. But like you, I had the same surgeon for both and have 100% confidence in him. I think that's half the battle - having a surgeon that you trust completely.

    My surgery lasted about 3 hours and I only spent one night in the hospital, just over 24 hours total. I had to wear a hard brace (Miami J collar) for one month then a soft collar for two months and I found it very comforting to have the added support and protection for my neck. I don't have a cage, but I have a plate with 8 screws (my levels were C4-7).

    With regards to driving, I couldn't drive until one month out because of the hard brace, and even then I was a little nervous until I got used to it. If you don't have to have one, I guess it will depend on what your doctor says and when your ROM is good enough to be comfortable seeing traffic when turning. This part of recover is really an individual thing as it depends on so many things - pain levels, medications, ROM, bracing, etc.

    As many will tell you (and you might already know because you've had a PLIF), the anticipation is usually worse than the surgery itself, so try not to worry too much. Easy for me to say even though I had an ACDF and was still scared leading up to my TLIF. But it'll be over before you know it and on to recovery. I can tell you that for me, the recovery from the ACDF, even a 3-lvl, was easier than the recovery from the TLIF, 1-lvl. I think that having to cut into those large muscles in the back make recovery much more difficult as they work to grow back together.

    Good luck, take care and please keep us posted.
  • I had c5/c7 done in March 2008. My experience was very similar to Cath's. My surgery lasted about two hours and I also have a titanium plate, not a cage. One night in the hospital and then home. I was released to drive after one week, but I was not ready to do that! Only did it to go to the doctor at the end of the first week, then would drive to work for a few hours. My neurosurgeon does not use collars at all because she feels that they weaken the neck muscles too much. I had no problems with my voice or swallowing. Yes, I felt that some restriction with swallowing, but it was never a problem and eventually went away. Hopefully you will have a smooth experience. Best of luck!
  • I had c4-c7 surgery in March. I have a plate, cage, screws, bolts, and cadiver bones. I don't think anything else will fit in my neck. My surgery was 6 hours. I still have problems choking/swallowing. I still have bad muscle spasms and hurt daily. I take Neurontin, Tramadol, Tizandine, and blood pressure medication. Some days are good and some days are bad. I have not drove since March, I don't have enough mobility. I have faith and hope I will one day be better. Keep positive thoughts and allow your body time to heal and keep your head up!!LOL, like we have choice anymore right?? Great Posture now. :) :)
  • RangerRRanger on da rangePosts: 805
    hey wonderboy,
    I am a little more than 3 years post-op of a anterior and posterior cervical fusion of C3 thru C6. Also some vertebrae and discs were removed and a strut was installed along with a cage. They ground up the vertebrae removed and installed it into the cage which has resulted in a very strong fusion. My fusion was 6 hours long due to the extra work involved. I also had rods installed in the back of my neck which are secured to the plates on the front side for added strength and stability.
    Confidence is everything, I share the same confidence in my medical health team as you and others here do. It benefits both mentally and physically.
    As for any swallowing issues, nothing really has changed too much but it is a little different than I was pre-op but no problems.
    Welcome to spine-health and wishing you the best and a speedy recovery.
  • I consider myself very lucky living in the UK as my operation will be 'free' courtesy of our wonderful NHS and will be carried out at a wonderful hospital, the Royal National Orthopaedic Hospital, Stanmore, Middlesex. I have had several operations there and all have been successful. I wish everyone having surgery in the future good luck. I will let you know how my operation goes.

    Previous operations - 2008 PLIF plus rebuild - 2006 Left Knee Replacement - 2000 Right Knee Replacement Revision - numerous spinal injections and burning out of back nerves all carried out successfully.
  • Hi again. I want to wish you a very successful surgery and a speedy recovery. I hope your nerves stay calm in the days leading up to surgery.

    Please do post back when you can after surgery and let us know how you're doing. Do you have to wear a brace afterwards? Do you have everything ready at home, like straws, your "station" (recliner for me), etc?

  • :H I had c4-c6 acdf, allograft, miami-J collar (will be in a collar 2-3 months), bio-absorbed plates, bone graft stimulator (cervial-stim by orthofix) therapy..2hrs/2xday for 6 months. I'm one week post op. I chose a neurosurgeon. After surgery I was having difficulty with pain but once they got that worked out I was up that evening and released the next day. I have a sore throat and some difficulty with swallowing but I can eat just about what I want just chew it really well. I still stick to softer, cooler foods like ice cream and pudding, shakes. It seems to get better everyday. I sleep in my recliner but after I visit the dr. tomorrow for incision check up I may buy the pillow that has an incline and under knee support. I think I'm doing really great. I'm needing pain meds less and less but still use amrix (time released flexeril) every evening which keeps my neck from getting too stiff. I can go some days without any pain meds but usually need some by the evening. After about 3-4 days I was up and about very regular. I help get my daughter out the door for school and even do very light housework. When I look at what was done (which pales in comparison to what others have endured) I'm really amazed that I feel as good as I do. I have seen the cage you are describing but I don't know the different reasons for using them over other techniques. It may be a surgeons preference or a physical need. Ask them. Best wishes for a quick recovery.
  • Have just returned home from my operation which I must admit was very painful in neck area. Surgeon said that everything went very well and that discs were replaced with titanium cages, bone grafts and also some work was done to vertebrae. Sleeping in bed is nigh on impossible so I have reverted to my recliner chair. No driving for 6-8 weeks this dependent on how soon everything bonds. Time of operation was only slightly over 3 hours. Sincerely hope this is my very last spinal operation! Thank you for all your support.Will not be able to swallow properly for 2-3 months and have very sore throat. Neck in soft brace.
  • Oh my, were you in the hospital for 7 whole days?

    Will you have any movement, be able to turn your head side to side or rotate at all?

    can you talk okay? bless your heart, I hope for you a speedy recovery!! and get some sleep! I)

    be well,
  • Wonderboy,

    Welcome to the other side! Glad to see you are home and all went well. Most sore throats only go a couple to three weeks. Hopefully it won't be like that for 2-3 months. Just rest and let your body heal, and above all follow your doctors instructions to the tee! Again, congrats, and welcome back!!

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • WooHoo, you're home and on to recovery. I'm so glad to hear that the surgery went well and fully understand how uncomfortable it is the first month or so afterwards.

    Take care and follow doc's orders. Make sure to take your meds to keep ahead of the pain and let other take care of you.

    I'm thinking of you and sending you a big, but gentle hug.
  • I am still having great trouble in swallowing and continue to choke if I attempt to eat anything semi solid. My physio called yesterday13.10.10 and massaged the back of my neck, both shoulders and all of my spine with massage balm with arnica.Since this I have had less muscle spasms. I am still wearing soft collar most of the day except for eating. Had a short spin in my 'new' car and felt quite comfortable although I shall not risk any lengthy journeys until I see my Surgeon on 11th November. Showering is not easy as one has to be ultra careful not to bend head down or up.My physio reckons it will be at least 6 months before I begin to feel anything like well. Just have to be patient again I guess. Been getting pain tweaks where I had a PLIF plus rebuild in December 2008. Has anyone suffered this sympton after an ACDF? Still very hopeful that one day I shall be able to play golf again! Good luck to you all.
  • Although everyone heals differently, if you actively engage in PT and work at building your core strength and flexibility, there should be nothing keeping you from the golf course in due time (once you are completely fused). I don't post much on here, but check back every once in a while. I had ACDF in 2008 and within a year I was back to playing golf. This past summer I played 3-4 times a week, including league. I can't hit it as far as I used to, but am a much better golfer now that I am more aware of my swing mechanics! I feel that my desire to get back on the course safely was one of the main components of a good recovery.
  • This is my fourth fusion surgery from two car accidents. While I've done well consider the amount of work they did this last time on 9/1/10 (C4-5 and C7-T1), the swallowing, esophageal spasms and heartburn are nasty. it's scaring me. I had some difficulty swallowing with my other surgeries, which were single fusions, but they corrected themselves within two weeks or so. I'm six weeks. I know that's not long, but it's freaking me out. My arms are better and my range of motion isn't bad at all. I'm doing physical therapy. Just wish these spasms in my esophageal area would go away. You are doing physical therapy?
    PS - I also had C5-6 and C6-7 done and healed well from them.
  • :))) I am almost 5 weeks down the line after C4,C5 and C6, ACDF operation and still suffering from choking when I try to eat solids! My Surgeon here in UK told me that it should return to normal after about 8 weeks so I have to be patient which is very difficult. Are you eating wearing a neck brace for I take my brace off and it does make swallowing easier.My physiotherapist massages my neck, back and sides and I find this stops a lot of the spasms. She uses massage balm with arnica which is strongly recommended. I do not keep my neck brace off for long periods as then my neck hurts trying to keep my head erect! It's a struggle but one which I will win for sure. Good luck and try to keep positive.
  • Wonderboy,

    I had my ACDF on August 3rd and I am still having difficulties with eating solid foods... choking on chicken skin, steak, pork chops ect.. Very frustrating at the least! Doc says everyone is different and heal differently! UGH!!! I have lost a lot of weight on the plus side of it! LOL.. It seems like my plate in my throat is right on the outside of my neck instead of where it really is.. I swallow a lot now and have water everywhere around my house, car and work! I am also still having trouble with my legs cramping but my right arm was better right after my surgery!! Which was totally awesome for me!! So my surgery wasn't a totally disaster!! Just ready to feel 100% again SOON!! :)
  • :H Sorry to hear that you are still having trouble swallowing solid food like I am experiencing. My swallowing has improved slightly since my physio started massage on my neck and shoulders with 'Massage Balm with Arnica'. It seems to ease my muscle spasms but like you I always have plenty water to hand. I see my Surgeon on 11th November for a post operative check so I shall tell you what he says with regards to the swallowing problem. Take good care of yourself.

  • Your incision sounds very long at 5 inches. Do you know if that is a normal length, or is there a reason why it is so long?

    What were your symptoms before surgery, and have they gone now?

    Hope that you continue well in your recovery and that the swallowing gets easier very soon. :-)
  • I am a bit worried now as I have severe numbness in all my toes, particularly bad in left foot. Has anyone suffered with this problem as it is affecting my walking and balance. Just when I thought everything was going really well with even the swallowing showing a slight improvement. Guess I shall just have to ask the Surgeon when I see him on 11th November. Due to get further facet joint injections!

    PLIF Surgery with rebuild of bottom of spine carried out in December 2008.
  • :Had appointment with my Surgeon today 11th November 2010 and he was very pleased with my operation. They gave me an Xray and he showed me the 3 cages plus metal work that I didn't realise I had! I have to wear my collar for another 3 months especially when I am driving and ensure I do not suddenly twist my neck but move shoulders with neck.
    They also gave me a check up on PLIF + rebuild operation I had in December 2008 as I have been suffering severe lower pain again. It appears there is swelling to L4, L5 and S1 so I have to get urgently facet joint injections in these areas which he said will be most difficult to do due to the fusion. Problem is metalwork appears to be pushing on nerve areas. Should injections not work he said unfortunately I would have to undergo further surgery to realign or remove all metalwork. Just when I thought I was finished with spinal operations!! Sometimes wish I had never undergone December 2008 operation but it was an emergency he told me. Anyway my swallowing should improve in another 4-6 weeks he said so I shall as always keep smiling and be optimistic as it does help!Apparently numbness in left foot and toes is caused by swelling to L5.
  • I'm glad to hear that the ACDF recovery is going well. It's always nice to have your surgeon say that you're on schedule and things look good. Wearing the neck brace is kind of a pain, but it's a great reminder not to twist or bend too much.

    Bummer about your lumbar swelling. I wonder if he'll add a medrol pack to help reduce the swelling (I don't know if the medrol even helps with facet joint swelling). Anyway, I really hope the FJIs help you. I've heard many members here say that the hardware removal surgery is much easier than the initial surgery, so if you end up having to have that done, it shouldn't be as bad as the initial surgery.

    Good luck on the injections, please keep us posted.
  • :))) Had a visit yesterday 28th September from my local District Nurse who changed my dressing and asked me if I wished to look in mirror to see length of incision on neck. I was shocked to discover it is some 3 inches plus. Wound has already healed very well and I feel I am on the road to recovery already.
    Swallowing remains a problem but getting easier as each day passes. Sleeping is still difficult even without my collar support. All in all everything is going very well.
  • I have been weaning myself off all painkillers slowly but think I shall have to start them again as I am getting what I have been told are nerve pains! How long before I can stop them for good and will these nerve pains subside soon? I am off in 2 weeks time to have the injections in L4, L5 and S1 and do hope they work for I do not wish to be opened up again.

    PLIF Surgery + rebuild lower spine - Dec. 2008
    Various spinal injections from 2003
    Rt Knee Replacement 1998 then Revision 2000 - Left Knee Replacement 2006
  • Well, that's just a big bummer that you have the problems again in the lumbar area, although I'm glad the cervical looks good. How's the swallowing now?

    I'm keeping my fingers crossed on the injections. I know that FJIs work for some, but they did nothing for me, thus my TLIF.

    I don't know how many of us will ever be off pain meds. Hubby and I personally don't think I will ever be able to function without them of some sort and especially muscle relaxants. Luckily, I don't have nerve pain, so I don't have to add nerve meds to the mix. Anyway, if you need to keep taking them and your doc approves, then do what you need to do to keep moving and keep going. I know that some, if not most, of us would be stuck in a chair somewhere if we didn't have something to take the edge off and allow us to get up and out.

    As always, please keep us posted. I'm thinking of you, buddy.

  • O:) I had my injections to my lower spine on Friday 10 Dec 2010 and actually had 6 to L1/2. L2/3, L3/4, L4/5 and 2 other areas around C1. Felt fine after them but today Saturday I am sore. Surgeon told me that he would see me in 6 weeks and hoped by then they would have had positive effect. If so he would repeat them again in Mch 2011. It is marvellous now after my ACDF operation to be able to eat solid food without choking. My neck however remains quite sore!

    Knee replacement rt 1998 with revision 2000
    Knee replacement lt 2006
    PLIF with major rebuild 2008
    ACDF with removal of 3 discs and fusion 2010
  • :))) Since I had injections on 10 December 2010 to L1/2, L2/3, L3/4, L4/5 and S1 numbness in both feet and toes seems to have become worse and is now affecting my balance! Has anyone suffered this problem since PLIF and ACDF Surgery?

    Rt knee replacement 1998 then revision 2000.
    Lt knee replacement 2006.
    PLIF + Rebuild in December 2008.
    ACDF on C4, C5 and C6 with Disc Removal and Replacement with Cages + Decompression 18 September 2010.
  • Thank you wonderboy- very helpful comments.
    I am due in 3 weeks a c5 c6 acdf in the UK by a neuro unit- diagnosed with csm, no arm pain, but very slight balance / rare clumsiness, and handwriting........ but there is spinal compression - mty specialist rates as a priority................
    Also have the spinal stenosis - so cannot stand for long or walk far..... but the csm is deemed most important, so the bit giving me the pain will have to wait.!!!

    Never had anything like this before for quite worried to say the least, whilst i have a smal part time job ( semi retired ) which i enjoy i am off as i cannot stand for long............

    any help - encouragement would help - thank you all

  • I was scheduled for 4/5/6 ACDF last February 2014 to be done by a surgeon that I think is amazing. I had been seeing him since I started having pain in my right trapezius/scapula which radiated down both biceps. He told me 11 years ago that surgery was the ONLY way to eliminate the pain. The pain was bad. Most days I had to drag myself to work and try to put in 8 hrs. Right before my surgery, a friend's wife had the same surgery from the same surgeon. He used a plate and screws, and did a 3 level discectomy 4/5/6, 3 level fusion with autograft and instrumentation. She had a hoarse voice for a year after. She couldn't swallow normally for months. I got scared watching her try to recover. I researched a ton and found a surgeon who uses the DePuy Synthes ZERO-P instrumentation which eliminated the need for a protruding plate which affects the swallowing (dysphasia) and the voice-vocal cord issues (Dysphonia)...well, in theory. The ZERO-P means, ZERO PROTRUSION. Supposedly to eliminate ALL swallowing issues. You WILL have swallowing problems once your surgery is complete. No matter the surgery. No matter the hardware used. The difference is, how much and for how long. The intubation tube is not your friend...it causes you to feel like you've swallowed broken glass or razor blades once it's removed. It is not meant to be in there. It wreaks havoc and it takes 2-5 days, depending on your ability to get over it. The retraction of your esophagus, trachea and neck muscles will make your neck sore and will make it hard to swallow. Yes, you will regurgitate and stuff will feel stuck. That will last a few weeks. For me, it lasted two to three. The key is, DON'T try and eat bread, dry meat, cake, etc. Be smart. Eat a balanced diet of protein/carb like oatmeal, yogurt, soup, softer type foods. If you keep up your regular eating habits and shove a burger in your face 3 days post OP, you will keep the swelling up and it will take longer to eliminate the symptoms.I decided to do the ZERO-P because Im thin, female and was afraid of the protruding plate. Two weeks into my recovery, I noticed unusual swelling in my neck. The doctor told me it was normal and prescribed a series of steroids to take. It immediately cured the swelling and it went back to normal. Still normal. Get the ZERO-P....
  • Thank you all for your posts.I think that by reading them it will prepare me more for my upcoming surgery. I should let my husband look at them too, as we are both rather nervous. As a mentioned earlier my elevator will be taken out of service the same day that I have my surgery. It will be out anywhere from 4-9 weeks. I will start taking the stairs now so that I will be used to it before surgery and hopefully will have the strength to make the 4 flights when I get home.
  • LizLiz Posts: 7,832

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
Sign In or Register to comment.