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Surgery ACDF C-4 - C-7

This is a first for me. I going to schedule my surgery, but I had a few questions.
1. Is there anything I can do prior to surgery that will increase and speed up my recovery?
2. I have a very high pain threshold, what meds do you recommend?
3. What can you tell me about bone Morphogenic protein?
4. What should I expect in two weeks post opt?
5. How much motion of the neck (range) will be lost?


  • Hi there, Steve:


    What has your surgeon told you? Have you had any significant discussions with him or her?

    Will you be wearing a collar? If so - hard collar? soft collar? If so, what is the doctor saying about how long? I was told from the start that with my two level fusion I would be wearing a collar for 3 months. Some do not wear collars at all. It depends on the levels, how many, age, etc etc.

    Do you smoke cigarettes? (Tobacco has been shown to inhibit fusion, so if you smoke - STOP NOW!)

    Do you know if your surgeon is recommending a bone growth stimulator to help the fusion process along?

    Do you know if you will be using cadaver bone or your own bone for the fusion?

    Loss of range of motion - check with your surgeon - I was told about 10% loss for each level fused. I had two levels fused and thankfully lost only a very little bit of range when turning my head to the left. Turning to the right, I lost none.

    When I had my fusion done - C3/4 and C4/5 - I was in a hard collar for 3 months, but I also wore a bone growth stimulator which sped up the bone fusion considerably. In about 3 months, I was almost fully fused.

    One of the things that I think most will agree with on here, especially with the number of levels you are having fused, don't rush things. You get one shot to get this right and while you may be in a rush to heal, that's a lot of levels and fusion takes time.

    I have a high pain tolerance, too but it is important to realize that it is a big surgery and you're having more levels done than I had done. There are no shortcuts to fusing.

    I was VERY lucky - for some reason, I never had any pain whatsoever, so I cannot help you with the pain meds. I did, however, lose my voice for 35 days. Every person is different and will have different reactions. thankfully, I planned to take time off and had email and texting to get me through.

    I would imagine you need a lot more information from your surgeon so that we can answer more, as much as I don't want to speak for anyone else on here.

    There are so many other things to do to prepare - a comfortable place to sleep when you get home (that is not likely going to be your bed), do you have someone there to help you if you need it, etc etc. But there is time to talk about all of that once you speak with your surgeon and get some more info.

    Believe me, you'll get a lot of responses from many on here with a lot of opinions, suggestions and recommendations once you have more to report. :)

    Please keep us posted!

    10/26/2012 ACDF C3/4 C4/5 surgery
    No pain; no pain meds - thank goodness!
    04/01/2013 - 5 months + 1 week - FUSED
    Doing some physical therapy for even better range of motion
  • Q1. Is there anything I can do prior to surgery that will increase and speed up my recovery?
    As Francine said, stop smoking if you smoke. This might apply to using chewing tobacco as well.
    Losing excess weight is always a plus and cardio exercise that increases lung and heart capacity.

    Q2. I have a very high pain threshold, what meds do you recommend?
    This can be a problem if you use this "ability" to do more than you should and doing too much the first few months can undo what the surgeon has done and drastically increase recovery time, if not prevent it. YOU MUST condition yourself to adhere to the lifting rules so that you don't put too much strain on your neck. For me it was not to lift more than 10 pounds the first month, 20 the second, and 30 the third. I am in my "30 pound cycle" which allows me to do most things I need to do. If I need to move something heavy I call my grandson for help. At the grocery store I ask for help getting the 30+ pound bag of dog food into the car. I also wore the hard collar for the first 5 weeks and after awhile I could hardly tell I was wearing it. The collar acts like a cast and prevents outrageous movement of the neck in all directions. Like a cast, when it comes off you will discover that your neck musculature has weakened and you will have some soreness as you work things back into shape..... SLOWLY.

    Q3. What can you tell me about bone Morphogenic protein?
    Interesting question. Does your doctor plan on using this treatment option? From what I have read it definitely has promise and it could shorten the amount of time needed for fusion. By how much is really the question. For myself, if fusion occurs naturally what is the upside to getting the fusion finished more quickly as opposed to possible unintended consequences for something like this that might result in too much growth or other unforeseen after affects.

    Q4. What should I expect in two weeks post opt?
    My experience was that of little pain and a lot of getting used to the collar. I have a bed that can be raised and that helped with sleeping. A recliner also works. I was always having a little trouble getting into a comfortable position. Overall though, the first two weeks were not bad considering the severity of the procedure. I was not allowed to drive until the doctor allowed me to ditch the hard collar. Since the end of week 5 I have not used a collar at all and things are going very well.

    Q5. How much motion of the neck (range) will be lost?
    From where you are now to after the surgery you should see no reduction and maybe an increase. It all depends upon how much it hurts now to turn you head. I feel that my range is greater and what I do have is smooth and painless. I don't push things now and won't until I get the "all clear" from the doctor.

    Question you didn't ask: What activities can I do after the surgery?
    1. You can bowl. A friend of mine had 3-level ACDF a few years back and bowls twice a week and still has a 200 average at 70+ years of age.
    2. You can play golf. Same friend is a 12 handicap and plays at least one each week. Davis Love, pro golfer, just had 2-level ACDF and expects to be back on the pro circuit later this spring.
    3. You can swim.
    4. You can run or jog.
    5. You CANNOT play pro football.
    6. Not sure about skiing or snowboarding.....

    Best of luck
    US Army Retired
    Olympia WA
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