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Home After 4 Level Anterior Cervical Disectomy and Fusion

ValgalVValgal Posts: 38
edited 06/11/2012 - 7:55 AM in Back Surgery and Neck Surgery
Just got home from 4 level ACDF, C3-C7 using four cages and BMP yesterday at 8am. (8-17)

So far, I've had little or no swelling and was up and walking yesterday afternoon with a little bit of nausea.
I had scrambled eggs for dinner. Scrambled eggs, grits, and cottage cheese for breakfast with prune juice :)

I was already on Tramadol and Neurontin and I doubt I will need my new RX of Xycodone after today and tonight. (I'm also on a boatload of other new meds: steriods for a week, muscle relaxer, antacid).

I am up and around at home with a little neck pain around the incision and shoulder blade muscle spasms but all my arm, shoulder and wrist pain and tingling is gone :)

I hope this helps some of those with the trepidation I was feeling last week. I do expect to run into some complications and challenges along the way but this surgery was really a piece of cake compared to what I thought it would be. (Way easier than a c-section,ladies!) :H

Anyone else out there have a good experience with 4 level ACDF?? I can't wait to go back to PT but have to wait two to four weeks.

Thanks everybody!
Valgal, 48 years old, mom to two sweet boys ages 5 and 6.

Diagnosis: Broad based disc protrusions C4-5, 5-6 and 6-7, anterolisthesis C3 on C4 second to facet DJD. Multilevel degenerative cervical spondylosis with kyphosis centered at C4, disc osteophype complexes C3-7, Multi level foraminal stenosis.


  • Welcome home! I told ya the anticipation is worse than the surgery. It's hard to fathom that, but it's really true.

    Now, be aware that you might feel pretty good today and tomorrow, but you might feel like you got hit by a truck in a day or two. When that sedation wears off completely, you might be telling a little different story. I hope not, but that's happened to a lot of us, so keep those pain pills handy.

    When I got home from the hospital after my 3-lvl ACDF, my hubby asked me if I could even just act like I'd just had major surgery, I was so gung ho. Then, two days later *WHAM* I was sidelined in my recliner for a while.

    I'm glad the arm issues were gone after surgery - that's not uncommon either. How's the swallowing? Sounds like you have a sore throat, but no big issues?

    Glad you posted and be sure to follow doc's orders. Walk when you can, rest when you need to, and no BLT (or housecleaning!!!).

    Take care and again, welcome to the other side.
  • Congrats on being on the other side!! I go in in 6 weeks to verify I have not smoked for 6 weeks; and if I am good (I plan on it!!) surgery shortly there after for 5 levels.

    One of the questions my hubby had was 'how long in the hospital' as my other two fusions were 24 hours. I am pleased and surprised to see at 4 you were out in 24. I actually like that!!! Hopefully the same will ring true for me.

    Please keep us posted on your progression. I agree with Cathy that you will feel tops for a few days, and as all that crap the anesthesiologist put in wears off, "ouch" mode will happen. Fingers crossed it is a mild transition. Again, welcome home!!

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Thanks, Cath 111!
    I'm prepared for tomorrow if I feel worse. I'm just relieved I didn't swell up or wake up with agonizing throat pain.

    I have no sore throat, though it does feel a little swollen.
    No swallowing issues except I just ate a raw carrot and it wasn't the easiest thing to swallow, won't be doing that again!

    I slept like a baby last night in the hospital, thanks to the ambien they gave me.

    I actually called my Dr. on Monday with second thoughts and asking for other options. He was very reassuring and answered all my concerns about BMP, four levels, etc.

    I loved hugging people with both arms today :)
    Will keep you posted on tomorrow, etc. I probably have done too much today but really just sat around with my mom and am making a roast chicken for dinner.
    Husband doing ALL housework and driving, and no work till at least September 21st.

    Hope your C3 and 4 aren't giving you too much trouble today.:)

  • Hi Brenda,

    I went in to the hospital at 6am, surgery at 8am, went home around noon today.

    I wanted to go home yesterday afternoon but no go.

    My doc put me in a soft collar yesterday but said I didn't need to sleep in it and today could take it off as long was I wasn't in the car, walking, or around small children and pets. I was surprised because I had heard so much about other people spending most of the day in their collars.

    Hang in there with the smoking! I smoked for more than 29 years and tried quitting a gazillion times. Believe it or not, going on the chats and forums for people with lung cancer and other diseases and looking at pics of diseased lungs helped me quit cold turkey. I'm smoke free for 6 years with no desire to start up again.:)
  • Val,

    Hopefully I too will be out of there in a day... My surgeon told me I *will* at a minimum be in a hard collar for 3 months. With my fusion, it is partly (the middle of it) a revision, and too it joins the cervical to the thoracic. This will all be done posteriorly.

    I did give him my hard collar preference of the Aspen - it is rather comfy for me! He just smiled.

    For my past 2 fusions, I was only in a hard collar for a little over a week, and soft for 2 weeks after that. Like you, "wear it in a car, around kids, out and about."

    As for smoking, congrats!! I've been smoking (inhaling that is) for 32 years, and with this huge surgery in front of me, the motivation is very high. My plan is cold turkey. I quit in the past, but the motivation was low, so the efforts failed. The good out of it though is I know physically what to expect. Fingers crossed tight!!! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Hi all,
    I have been reading your posts in regards to surgerys. I had mine done July 5th, and still in pain, other different pain sensations. They say it will pass. This week was the first time that I actually could swallow something without backing it with water to push it down. I have been using a spondeltyis bone stimulator for 13 days now, and I do hate it. I feel it makes me in worse pain, however I can hold my head up longer during the day.
    At first i thought I was gong crazy and mad at the Doctor, because nerves felt like they were jumping in my body and I get nausea and dizzy after using it for 30 minutes every night. I go for my 8 week checkup August 30th which at that time I will have an X-Ray. I guess I just need to be positive that all is going well.
    I get tired very easy. I try to do things rather than laying down all the time.Are any of you driving at 6 weeks out? I also have a rotor cuff tear which is not taken care of yet. That was the first issue why I went to doc in the first place, The orthropedic gave me a shot, and sent me within 5 minutes to the Neorsurgeon as 4 bones spurs were pushing into my spinal and 2 disks crushed. So that was prior. I just wonder if anyone has still have different pain sensations in shoulders and sometimes down arms. Night time is terriable. I was told that this is all normal. It isn't the same pain I had before surgery. ????I have to wear this hard color July-September. Hey on the soft coloars to dress it up. A friend made me different colors to go with different outfits. I thought that was so cool. The medical company should do desighns. Prayers for all. Just concerned and venting. I did have 8 screws and a plate put in.
  • First off, Welcome to Spine Health! Presently my levels I had surgery (fusion - ACDF) on is C5/6 & C6/7. Due to the fusion failing and causing additional issues, within 2 months they will fuse me at 5 levels. Recovery for it will be over a year assuming no further issues happen.

    You are just hitting 6 weeks, and had 3 levels fused. That is a big surgery, and too your whole spine is affected by it forever. The loading and dynamics have now been changed, and it will take time for your spine, muscles, ligaments etc., to adjust and settle down. The other, the nerves... Nerves really hate being compressed and take a while to recover.

    To give you a small idea. We'll all had our leg/foot fall asleep right? What happens as it 'wakes up?' It stings, it hurts! Okay, with that image in mind, now picture your nerves and nerve roots in your spine are now free, and they are trying to wake up. They heal at about 1mm a day, so it can take a while.

    Pain in the shoulders, back, neck from spasms can go on for months! I know from my surgeries and recoveries, had them pretty frequently for the first 6 months, and then they started to back down. Muscle relaxers can also help.

    Driving: for both of my recoveries I was driving around week 6 or 7. This one coming up most likely won't be driving for over 3 months! And depending how much range of motion, driving might be a thing of the past for me - time will tell.

    Just remember, try to judge your recovery by weeks and not days. You will have your good days and bad, and then of course the in between types of days. Try to walk to keep your oxygen rates up for the best healing, try to eat healthy, and rest where you can. Please let us know how it goes.

    Again, Welcome aboard!!!!

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • My 4 level ACDF was Wednesday morning. I still feel rapid improvement!

    Sleeping at home was a bit painful in my neck last night, mostly in front where the incision is.

    But all my arm and shoulder pain, tingling and numbness is still 99 percent gone :)

    I am supposed to walk as much as I can so I went shopping today with my mom driving. I feel better the more I am on my feet, not sitting, though I did spend about an hour on the computer. Need to work out the ergonomics once and for all and can't wait to get back to PT to work on that.

    I do feel swelling in my throat but today ate more scrambled eggs, cottage cheese, roast chicken, pizza, salad and quiche.

    Thanks so much for all your feedback and help, will keep you posted. My mom has been here for 3 days but is leaving tomorrow; I won't feel ready to drive till at least a week since my head doesn't turn far in either direction. My husband will be in charge of the boys and the driving so my recovery continues...

  • Val,

    I'm still a little jealous here. I was told to expect between 3 and 5 days if all goes well in the hospital. Maybe since my will fuse cervical to thoracic makes it different?

    So glad to hear all is going well. Yeah, walking, walking, walking...been there, done that, about to do that again! (G)

    My ROM already sucks, but one good thing, get creative with your car mirrors when you start driving again. I have a feeling my driving days will be very much reduced once cleared. Don't push yourself, tell your body to keep up the good work!! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Brenda, I would guess since they are having to Redo a failed fusion that's a lot more complicated and invasive PLUS it's posterior. Mine was anterior.
    It really has been much easier than expected and today I'm just trying not to overdo it.

    Also, I'm not sure what meds everyone else's neuro had them on post op but I am taking a boatload!
    Gabapentin: from before surgery, still taking
    Tramadol: from before surgery not still taking although I'm supposed to.
    Methocarbamol 750 mg: Muscle relaxer to prevent shoulder blade spasm reaction to ACDF
    Oxycodone: 5gm, 1 to 2 caps every 4 to 6 hours, don't really need this one today.
    Dexamethasone: Steriod to prevent swelling from BMP, taking decreasing doses for 8 days

    Anyone else who has had 4 level ACDF, how soon and far could you turn your head up or down or to the sides? I don't think I'm even supposed to be trying yet.. but it really doesn't want to go anywhere.

    I'm still loving how my arms feel though!!weeee!
  • Val,

    Sorry, seeing stars, hit myself too hard in the head for missing that detail! Anterior for sure could be the big difference. My two prior ACDFs were anterior, and I was in and out in 24 hours. Smack! I'm sure if I go back to your original post in here, you said anterior, and my little bitty brain missed it! (G)

    Heh... I'll blame it on Lyrica! (G) Mine were 1 level each, but my surgeon didn't want me to be moving my head around too much until he cleared me. You with multiple levels, I would bet even more so on the caution.

    It sounds like you're doing great, but keep in mind you will probably have your ups and downs for good weeks and bad. It's all sounding so good though. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Yeah, well this is my first time "at the rodeo" so to speak, so I'm full of optimism. I haven't been down the long road many of you have.

    I'm glad you have a doc you are happy and confident with who pays attention to you! I think that is key.

    Will be looking for when get a surgery date!
  • Val,

    Oh, by the way, my sisters name is Valerie!!

    Recovery from 'frontal' entry is easier than the rear. Less muscles messed with and such, plus smaller incisions. Normally they only go through the back (from what I've been told, and too researched) is to restore stability, fractures or for some surgeons multiple levels. Apparently your surgeon didn't see instability with you, so was able to get all done from the front. Excellent!!

    I see my OS on Sept. 30th, so I will know the date then, and of course will pass that on. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • How far can anyone turn their neck to either side or look up or down after a four level ACDF? I'm trying to figure out what this is going to be like a few months out. Right now I have very limited mobility at all.
    Also, any tips to speed up fusion, other than a high protein diet, which I'm on?
  • Okay, I'm now one week out. Still pretty tired depending on how I slept the night before. I've taken a few 45 minute walks.

    My dressings are now off, and while the incision looks pretty good, (very very thin) it's got an egg shaped swelling underneath. What is that? Normal? Guess I'll give it a day or two before calling the doctor again.

    Anyone hear of such a weird egg shaped lump under the scar?

  • How long have you had the lump? Do you feel like it is effecting your breathing or ability to swallow?
    If you are having any issues, don't hesitate to give your surgeon a call tomorrow.

  • Nope it's kind of firm but doesn't hurt. Just kind of a big lump under the incision.
    Not affecting breathing, I just want it gone!!! :)

  • My incision was very lumpy. I had a lump at the bottom of it, but the whole thing was fairly lumpy and numb. I was numb from the bottom of my neck up into my chin for months!

    I think lumps are normal, but I'd keep an eye on it and if it gets larger, call your doc.

    I'm very happy to hear that you're doing so well. It will hopefully give others some comfort that have upcoming cervical surgeries.

    As for the ROM, I had a 3-lvl, but my ROM is pretty good. I'll never be able to put my chin to my chest and looking up for any length of time is difficult, but left and right isn't too bad, especially after PT. But with a 4-lvl, I'm not sure. It's really amazing how much ROM you eventually have after you heal and back to a normal life. Mostly, it's just a problem keeping your head turned any way for a period of time that continues to be difficult.

    Take care Val and thanks for keep us up-to-date.
  • Like Cathie... I had a "lump" feeling under my incisions (and they were at that time one level each)...one even oozed "green" stuff (eww).

    Mine never got "hard", but puffy? My surgeons first question when I called due to concern.... "is it warm, do you have a fever?" For me, the answer was no. The way our skin (err incisions) heal can be cagie? Hopefully your's will be found to be "normal healing" process. Please keep us posted on how it goes. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • For the past two nights I've been awake with shooting pains from my knees to my ankles. My legs feel weaker than they did last week. Could this be at all related to ACDF two weeks ago? It seems pretty random but its kind of disturbing.
  • For the past two nights I've been awake with shooting pains from my knees to my ankles. My legs feel weaker than they did last week. Could this be at all related to ACDF two weeks ago? It seems pretty random but its kind of disturbing.
  • Is it possible you've overdone it a bit on the walking? You are real early in your recovery, and I have a feeling you will find all manner of "things" hurt, burn, ache etc. as you heal. I thought it was great how well you felt out of surgery, but I waited to see if you would have "some aches and pains, and minor set backs" which is normal!

    Until early October, my cervical surgeries have been one level each, but failure of my fusions (apparently 2 years ago, but recently discovered) screwed most of my neck. Revision and the addition of 3 levels from the back is not a flavorful feeling for the last 3 years. Like Cindy "Neck of Steel" says, you only have one neck...protect it! :)

    I hope you feel better soon - but my guess is it is NOT from your neck, but maybe overdoing things.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I'm in the same boat at you - I just found this forum. Wish I found it before surgery! I had a 3 level ACDF on August 29th - C4-C7. I have so much to learn about the healing process. I've read all your posts and are sending prayers your way that you are all healing and doing well.

    I'm surprised I feel as good as I do 9 days out. Had horrible arm pain before. 3 epidurals prior to surgery helped them, but the pain was coming back right before surgery. I too have a lump on my back and feel like I'm carry a 10 lb weight between my shoulder blades. I 've been on heavy pain meds and muscle relaxant so I slept so much of my first week. We bought a used hospital bed and it really helped me get comfortable...

    Can I ask why some fusions fail? Is there something we can do to help them along and what happens when they fuse - more surgery like Brenda is talking about?

    Thanks for any words of advice.

    Sandy in FL... (47 yo married female)
  • I imagine that it is nerve pain from the swelling caused by the BMP.

    Usually they don't use BMP in the neck due to swelling. My NS said they only like to use on patients that really need it do to arthitis. That is probably why they have you on steroids- to reduce the swelling. Swelling is a good thing since it promotes fusion, but there isn't alot of room in your spinal cord near the neck o we have to be careful :)

    I would put a call into your surgeon just to be safe.

    Feel better,

  • Howdy and Welcome to Spine Health!! Glad to hear you are healing well. My opinion on what can cause a fusion to fail:

    1. Smoking - Nicotine and too the chemicals.
    2. Low bone density.
    3. Weak bone structure.
    4. Hardware failure.
    5. Overgrowth - they used Osteocell on my 2nd fusion.

    Smoking is marked by many experts as one of the (if not THE) leading contributor to failure to fuse. I was a smoker, and the first fusion went great. They also used a straight bone graph. The 2nd one they used different hardware to anchor, and also Osteocell (a BMP baby brother).

    Based on the abuse my vocal cords took, and still do, the swelling shown in the MRI's and the position now of 5 of my vertebra, mine was a mix of overgrowth and yeah...smoking. With 5-6 levels coming up (C3/4...won't know till he gets in there), I am NOT taking any chances, so the ciggies went bye-bye almost 3 weeks ago.

    In just that short time lots of positive changes are felt, and too 'found' by my GP on exam. I'm hoping that in less than 4 weeks 5-6 levels will be stable and fused!! (G) Again, these are just my opinions.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Hi Brenda, thanks for the response. My heart goes out to you. I couldn't imagine having to go thru this over and over, and so many levels. I thought 3 were so many until I read your post! I do hope that you have good results. How soon is your surgery? So you had 2 spinal surgeries for fusion, one level at a time. I guess I'm lucky I did 3 at ones. All the rest of my spine looked great. I did have spurs on both left and right side, so he removed then all. Only my left side gave me pain, but he said without surgery good chance it would have happened on the right side in time. I have no regrets at all. I as so super scared, fearing I'd be so much worse than I am. I'm getting out and walking each day, which probably helps. my throat was burning first 3 days, a lump in throat and constant swallowing days 4-7. Now just have to eat soft foods and they still get 'stuck' somehow. Not sure I understand it. I just know I had many people sending up prayers and I am grateful for everyone of them.

    Is it different when you already have a spinal surgery and need another? I hope you continue to feel ok as you get closer to your surgery. I guess this is another good reason to be grateful that I am not a smoker..

  • Howdy Sandy,

    My pre-surgical clearance physical is 9/30, so I should have surgery within that week. Since it takes a few days to come back, I asked my GP for full blood panels, and urine testing. The rest, EKG, chest x-ray, (for me, nicotine testing), general health etc., this pre-strike should cut a it of time.

    My first 2 were anterior, this one will be fully posterior - which is virgin territory, so no scar tissue issues. :) Recovery from the posterior can be a bugger as I have been told, so we'll see. So's not to hijack in here, please see my sig, and too click my name for the Cliff notes. (G)

    I'm glad all is going well, and hopefully that will continue to be the case. Please for sure keep us posted. Believe it or not, many of us when similar surgeries are coming up, we look for those folks. Of late mine have been the multi-levels, and the posterior ones - especially with revision included. We all react differently, and too our surgeons might do something ever so different, so we never know who we are helping with our medical goodies!!! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Yay you did it! Congrats on each day you go smoke free.

    I'm feeling really good, the 3 day knee pain episode disappeared magically.

    Lump under incision is getting smaller.. some neck pain still but nearly all arm pain is gone. Had a great four day weekend at the beach, lots of walking and one of the most comfortable car rides I've had in 10 years.

    I have some trepidation about my Dr. Appt on 9-13 since I've been a little too active, and also spent too much time on the computer and a couple of "jostling" accidents from my hapless little boys.

    We shall see! Still not back at work yet :)
  • Hi Valgal - I would love to go walk on the beach but i'm too early in recovery yet. I am up to 1/2 mile. How long was it after your surgery that you felt good enough to go to the beach.

    Please let us know how you do on your dr visit. I go on Thursday for my wound check. These steri strips itch and pull.. Mine are stuck on there like cement still. Did the doctor takes your off, and if so did it hurt? At my aptm Thursday it will be 11 days post op.

    Thanks again for all the advice!

  • My surgery was August 17th, 4 levels, c3-7. My steri strips kind of wore off and I'm using heavy sunscreen, bandaids and Moderma, though I'm skeptical about it. Some days I walk 2 miles and some zero, or do a little light shopping :)
    I've noticed my energy level seems to fluctuate a lot!

    I'm NERVOUS about trying to work on posture, whether my fusion is "taking" and how to prevent further problems, hopefully you all can help me with these things.

    I got an awesome neck pillow at Costco that I Love that was 19.99!

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