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4 level acdf dr says 5 days in hospital

I am scheduled for 4 level ACDF surgery in January. My doctor told me 5 days in hospital and 3 months in a collar. That seems extreme. I am hoping he neglected to say "up to".

Has anyone stayed 5 days in the hospital?


4 level ACDF completed on January 3rd.
I developed an infection which required reopening the wound on January17th
Looking forward to life without as much pain!


  • part seems extreme? I would say is that all to the 5days part. You are having a major body changing surgery and it should not be looked at as just another procedure.
  • Penny,

    That could be true about the 5 day stay in the hospital, as you are having major surgery. While the name of the surgery is the same for everyone, depending on what they have to do during surgery depends on how long you will be in the hospital. As far as the collar goes that sounds right. for a 4 level. Be thankful it is just a collar and not a miami j or Aspen. I spent 3 months in a miami j. But most people actually find the collar a safety thing as it reminds them not to do certain things. Now the Miami j, for me felt good, as I had gone so long trying to hold my head up that the brace was welcome relief. Whatever you do follow your doctors orders to the letter, you don't want to have to go through a revision.
  • Fortunately I am having the surgery in the winter as a collar in Florida would be miserable so I'll try not to complain too much. As far as the hospital, I guess I will just have to put my big girl panties on and get through it.

    Good advice, Tam. That will be a struggle for me, I am so used to doing what I want.
    4 level ACDF completed on January 3rd.
    I developed an infection which required reopening the wound on January17th
    Looking forward to life without as much pain!

  • a 4 level ACDF is a big surgery, so the 5 days in hospital is probably quite correct.
    I am having a 2 level ACDF in 2 weeks (!!!) and will be in from the Monday until the Thursday.
    I won't be having a collar, but am in the UK where they are less commonly used.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,368
    edited 10/21/2012 - 12:02 PM
    Everyones neck is different ... everyones complications are unique, most of us have diferrent surgeons,at different hospitals. There are NO standards to go by as each situation and degree of pathology is unique. I was a 2 level revision after 1.5 years of fusion failure, I was in halo traction in ICU for 3 days and in the hospital a total of 8 days. Five surgeries over three different surgical days. Comparisons? Oh please, here's a dollar, buy a clue. Throw a quarter and try to land it in the big plate!

    Spine-Health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!  (Click on Welcome to Spine-Health)

  • Hi Penny,

    I have to agree with both Tam Tam, & Metal Neck. This is a Big Surgery, and Yes everyone is Unique. It's not just a
    little procedure, I had a 3 level just over 2 years ago, and am looking at revision surgery as bone spurs have grown back,
    and my c6 & c7 failed. I did not require a collar per my surgeon, but I went and bought a soft collar and I find to this day
    I use the collar when I am a passenger in a car, when I have lifting to do ect. The collar is Best Friend as it gives my neck
    the rest it needs Still to this day, and I am sure that I will use my collar for the rest of my life. I just tried sleeping with the
    soft collar as I am finding it helps alot with support during sleep.


    ACDF C4-C7 5/13/2010. Synthetic Bone Graft Failed Fusion.
    PCF C4-C7 8/13/13. Rods and Screws Fused in 3 Months with Autograft.
    C6-C7 Spineous process Surgically Shaved Off 3/11/14.
  • I think it is a fair question to ask how many days others spend in the hospital and yes I know each patient is different. Each condition different. After reading on a lot of forums, including this one, most folks seemed to be hospitalized for only a day or two. I have compression and spurring with pain and numbness. I am not in some immediate danger of cord damage as many are. I guess I just wanted some reassurance. This is a big scary surgery and telling me to get a clue doesn't really help. (Many say, I haven't had a clue in years, but that's another story)

    Jelly, good luck with your surgery. Are you nervous??
    4 level ACDF completed on January 3rd.
    I developed an infection which required reopening the wound on January17th
    Looking forward to life without as much pain!

  • I am trying to place myself in God's hands, and trust Him to look after me.
    I did that before my lumbar fusion and received amazing peace and had an excellent recovery.

    Mostly I am feeling calm, but I do notice that if I have other stresses, I am not coping as well as I would normally.
    Two weeks today!!!

    Have you got a date in January yet?
    Have you had any previous spinal surgery?

  • PennyPPenny Posts: 162
    edited 10/22/2012 - 7:13 AM
    No, previous spine surgery. My day is January 22. My doctor was scheduling a couple of months out and I decided to wait one more and go for the high option insurance. I know you UK folks don't have to worry about that but it means way less money out of my pocket.

    I understand the whole stress thing. Sometimes, just the pain makes me less able to cope.
    4 level ACDF completed on January 3rd.
    I developed an infection which required reopening the wound on January17th
    Looking forward to life without as much pain!
  • MetalneckMetalneck Island of Misfit toysPosts: 1,368
    My greatest hope for you is that you are in the hospital for exactally that 5 days that your surgeon said you would be. Heck I hope you only need to be in overnight or same day outpatient. But my desires have nothing to do with the realites of what is going on in your neck, how extensive your surgery might be etc, etc.

    I will admit that I am overly sensitive to this issue because my first surgery was down played by my surgeon and staff etc.
    I was dischaged after one night and like a dummy returned to work 12 days later. This all lead to me needing to have the entire surgery redone 1.5 years of H-LL later. I wasn't smart enough to ask enough questions - I didn't spend the dollar and buy a clue and demand more realistic guidelines and time frames.

    Again I hope that everything goes exactaly as you surgeon has stated it will. I didn't mean for my comment to offend you.

    Why are you questioning the 5 days?

    With concern,

    Spine-Health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!  (Click on Welcome to Spine-Health)

  • I had a 4 level ACDF in May of 2011 and I was in the hospital 5 days. It was about 5 hours from the time I was wheeled into the OR and when my family saw me in recovery (I didn't remember seeing them). I woke up in ICU - my doctor routinely arranges for 4 level ACDFs to be observed in the ICU before going to a MedSurg. I woke up still intubated - I was told it was a possibility depending on the amount of swelling in the throat. Pain was controlled pretty well. The next day the tube was removed. Day 3 moved to MedSurg and started walking with a walker around the halls. Next two days included PT. I thought the timing was good for me - being there 5 days. You didn't mention if you had other surgeries. It's hard to explain how it felt - out of it and really week. My family told me they could see the improvement from one day to the next.

    You can PM me if you have other questions.
    4 level ACDF C4-C7 5-2-11, laminectomy & discectomy L4-L5 1/26/12, ALIF L4-5, L5-S1 12/10/12.

  • I have been told that I will be in the High Dependency Unit after my surgery.
    I really hope that I don't wake still intubated. I suppose if you are well sedated, it won't be too bad.
  • Metal, in all my research online and reaching out to people who have had the surgery, none stayed more than a couple of days.Now I realize that is probably because of the number of levels I am having done.Part of my problem is the length of time till surgery, 3 months. I am pretty nervous (as you can probably tell) and the long wait is not helping. When I had the doctors appointment to discuss surgery, I had a long wait, by the time I saw him, I was in terrible pain, hungry and not thinking straight. I realized the next day, I have several questions I did not ask. My husband is coming along on my pre-op visit so that doesn't happen again.

    From Karen's description, it sounds like I will need all of those days. Thanks Karen for the explanation, that helps a lot and I will ask about the intubation.

    I'm with you Jelly, I hope I don't wake up intubated!
    4 level ACDF completed on January 3rd.
    I developed an infection which required reopening the wound on January17th
    Looking forward to life without as much pain!

  • After my appointment with my neurosurgeon, like you, I thought of all sorts of questions that I wished I had asked.
    I wrote to him with the most improtant questions, and he wrote back with the answers.
    I would imagine that it must happen frequently and they are used to it.

    I hope that you do manage to get some answers. It is important to settle our minds and have peace about going forward with surgery.

    Those 3 months will go very quickly. Can you arrange something to look forward to in the meantime? Perhaps something special for Christmas or New Year. Anything to concentrate your mind on something else while you are waiting.
    You may be released earlier after surgery if you are doing well. I would rather go home earlier than planned due to a great recovery than have to stay in longer than planned due to complications.

    Take care,
  • Penny,
    I had a 4 level (C3-C7) ACDF in Dec 2009. I was only in the hospital overnight (a 23 hour stay). I can't really say why your stay is so long. Although another day wouldn't have hurt my feelings any, I don't feel like I was released too early either. Maybe something that could affect the stay is how the surgery is done or the hardware that is used. (just my theory) Most people, from what I understand, have cages put in place of the discs and then a plate on the front with screws to hold everything in place. My doctor used the PEEK Prevail device made by Medtronics (you can google it if you'd like to see it)so I don't have any cages or plates. I was in a soft collar for 4 weeks (I think) and couldn't even be IN a car for that time either.
    Just an idea on asking your doctor questions....I wrote down every question I wanted answered and left space below for me to write the answer as my doctor told it to me. I even had printed out some stuff and had everything in a 3 ring binder so it wouldn't get messed up and so I could refer back to as I pondered over the questions again.
    Anyway, I hope and pray for the best for with your surgery and we will be here for support during your recovery.

  • i had three level c5/6/7 surgery in may, 2 cages, synthetic bone, top plate and 6 screws, i went in the night before because i am diabetic on insulin. had my surgery and came out by lunchtime the next day...... think it helped that the hosp were dreadfully short of beds.

    i had been told i would wake up intubated on high dependancy, i didnt and was on high dependancy but because i chose not to use the morphine pump (morphine makes me feel ill, i prefer just the pain to having the pain and feeling ill) so surgeon said i could go home... i felt great so went... but please, they give you plenty of pain relief during the op and it takes a few days to wear off, then i wished i had stayed a while longer!

    still having issues but my chord compression had been there a while so have myelopathy symptoms that may or may not improve, so far it looks unlikely.

    now having lower lumber issues so back to see surgeon on monday to see whats happening.

    good luck, be prepared and make things as easy as you can for yourself, then there comes a time when you just have to trust your surgeon to use his skill.

  • What are the myelopathy symptoms that you have?
    Just to encourage you, my surgeon has said that we won't know what relief I will get from this surgery until 6 to 12 months after surgery. So there is still time for you to improve.
    What did you use for pain relief in the hospital?
    What about once you got home?
    Did you have stitches, staples or glue?

    Sorry to hear that you are now having lower lumber issues. Good luck on Monday and I hope you will have a helpful appointment. Please let us know how you get on.
  • my scar is so incredibly neat, are they called sterry strips? the paper stitches, lots of them, which i really did leave alone, i showered after a few days without the dressing but still didnt touch the strips until they came away on their own. my scar looks like a line on my neck already (well ok it is still a bit raised but i was expecting to look like frankenstein and really its nothing). the myelopathy i still have, the preop pain is still very much there, the weakness in my right arm and hand is quite bad, and my legs still give way now and then but most people go through loads of stages before surgery, i was being treated for 5 years for shoulder problems as the docs wanted to "deal with one thing at a time" when it was my neck that needed attention, so first mri sent me straight to surgery.

    i only used paracetamol for pain in hospital, i have a high pain tolerance level and am terrified of getting addicted to medication.... i still use codiene and paracetamol at night and amitriptaline for muscle relaxant, so that i can sleep with the pain (sometimes it works, spend a lots of nights counting sheep until i get up in the morning!) but i wont take tablets during the day. i am on insulin anyway and recon there is a limit of stuff you can put in your body before you have to pay a price for it! (although i wouldnt suggest anyone else putting up with pain if there is help available for them, this is a personal choice.)

    i am still not back to work yet, or driving, i was just about too when my lower back and legs got worse, so waiting again now... but i am not paralysed from neck down so must be considered a success!! ;-)

    will let you know what happens on monday
  • jellyhalljjellyhall Posts: 4,372
    edited 10/26/2012 - 1:58 AM
    Yes, steri-strips, I think. I wonder what my surgeon's preference will be. I had staples with my lumbar fusion but am hoping for something neater on my neck! I had problems with my incision opening up at the top, even while the staples were still in. I don't know if they were not in quite right or if I moved and that caused the wound to open up. Anyway, the open wound got an infection and then over granulation tissue that had to be cauterised with silver nitrate. I couldn't take the dressing of for 6 weeks. Everything did heal up ok in the end, but I do have a much wider scar at the top where the problem was.

    My neck has been brewing for a long time too. Before my lumbar fusion 2 and 1/2 years ago, I was having several symptoms in my arms and hands along with neck and shoulder pain. Now I realise that it was all from my neck. The surgeon who did my lumbar fusion did tell me that it was not going to help my arm and hand symptoms because that was coming from my neck. He said we would sort that out next!! I thought he was joking. Little did I know!

    I find when I wake in the night and can't get back to sleep, the best thing is to get up and take a walk around the house. Then when I go back to bed, usually I can get back to sleep again. Just that walking about seems to get things more comfortable. Have you tried that?

    I am sending you a PM with a copy of a poem I have written about my surgery!
  • It really does help to know what others have gone through and some still going through. I am starting my list of questions, I have already spoken with the doctor's surgery coordinator once and she said to call with any questions, even if I think they are silly.
    4 level ACDF completed on January 3rd.
    I developed an infection which required reopening the wound on January17th
    Looking forward to life without as much pain!
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