What to Expect After Anterior Cervical Fusion Surgery

Dr. Constantine Toumbis

14 June 2021

Anterior cervical discectomy and fusion (ACDF) is a procedure that’s designed to remove an injured disc from the neck region of your spine, also known as the cervical spine. This procedure alleviates pain by decompressing the affected nerve roots and spinal cord. 

During the procedure, your surgeon will make an incision at the front of the neck. They will then remove the damaged disc and replace it with an interbody spacer. Bone graft, plates and screws are used to promote fusion between the discs.

Read on to learn what to expect after ACDF surgery and if you may be a candidate.

Conditions That May Require ACDF Surgery

Cervical spinal fusion is typically used to treat a herniated disc, cervical stenosis or Degenerative Disc Disease. Neck pain is the most common symptom of these conditions, however, a range of other symptoms may occur. 

Herniated Disc 

Herniated discs are typically caused by the wear and tear of aging, and in rare cases, a traumatic injury. The most common symptom of disc herniation is pain — which varies depending on the location of the herniated disc and the extent of the damage. If you have a herniated disc in your cervical spine, you may experience sharp or dull pain in your neck or between your shoulder blades. This pain may be accompanied by tingling or numbness in the shoulders and arms and may radiate down into your hands and fingers. 

Spinal Stenosis

Spinal stenosis occurs when the spinal canal becomes narrow and crowds and pinches the nerves in the spinal cord. Symptoms of stenosis include trouble balancing and walking, weakness, tingling and numbness in the extremities, and neck pain. Stenosis can be caused by the progression of other diseases including Degenerative Disc Disease, scoliosis, disc herniation and more.

Degenerative Disc Disease

Degenerative Disc Disease involves age-related changes to your discs, ligaments and vertebrae. These changes can cause pain, stiffness, fatigue and decreased flexibility. Some may develop bony growths (bone spurs) that compress and irritate the surrounding nerves, causing numbness, tingling and sharp pain that radiates into the extremities. 

When to Seek Immediate Medical Attention

There are certain types of neck and back pain you should never ignore — especially if they’re accompanied by the following symptoms: 

  • Chest pain or pressure 
  • Fever, headache or stiffness 
  • Weakness, tingling, numbness or pain that radiates into your extremities
  • Swollen glands in the neck 
  • Incontinence 
  • Pain resulting from a traumatic injury

If you’re experiencing neck pain accompanied by these symptoms, seek medical attention immediately as this can be an indication of a serious medical condition. 

Risks of ACDF Surgery

The success rate of cervical spinal fusion is high, however, as with any surgery, there is some risk involved. The level of risk varies from person to person and depends on your unique risk factors, other health conditions, the extent of your injury, lifestyle choices and more. 

Risks specific to anterior cervical discectomy and fusion surgery include: 

  • Incision infection
  • Difficulty swallowing and speaking
  • Spinal fluid leakage 
  • Nerve or spinal cord damage
  • Damage to the trachea, esophagus or larynx 
  • Fusion failure, also known as pseudarthrosis 
  • Mechanical issues with the bone graft, screws and plate
  • Arterial damage that can lead to excessive bleeding, stroke or death

Restrictions After ACDF Surgery

After your procedure, your doctor will provide you a list of instructions to promote a smooth recovery. These guidelines may include do’s and don'ts such as:



Wear your neck brace as instructed 

Bend, twist or tilt your neck 

Manage your pain as directed 

Lift items that weigh 10 pounds or more

Maintain a healthy diet and stay hydrated, drinking eight cups of water per day

Use tobacco products or alcohol

Keep your incision dry 

Participate in physically demanding activities 

Get enough sleep and take rest breaks as needed 

Stay sedentary for long periods of time 

Attend all follow-up appointments and physical therapy sessions

Resume activities before you’re cleared to do so

Have a friend or family member help you with driving, grocery shopping and other activities until you’re able to do them yourself

Take NSAIDs to alleviate pain such as ibuprofen or Aspirin until directed by your care team, as these may hinder bone healing


In addition to following your doctor’s guidelines, keep an eye out for post-procedure red flags including: 

  • Fever 
  • Chills 
  • Difficulty swallowing or breathing 
  • Severe pain or stiffness in the neck
  • Swelling, fluid drainage, bleeding, redness, a foul smell or warmth at your incision site

If you experience these symptoms, contact your doctor as soon as possible. 

Recovery After ACDF Surgery

Pain is to be expected after spinal surgery — your doctor may prescribe medications to help you find relief along with at-home pain management remedies such as using ice packs. After your procedure, you will be required to wear a cervical collar to limit mobility and provide support during recovery. 

Because the neck is a very complex part of the body, recovery times vary between patients. Some factors that impact recovery time include your overall health and lifestyle choices, complications during or after the procedure and how closely you follow your recovery instructions. 

Typically, patients make a full recovery within two to six weeks. After you recover from anterior cervical discectomy and fusion surgery, you should be able to resume regular activity with your range of motion impacted minimally, if at all. You should expect to experience pain relief and as a result, improved quality of life.

Determine if ACDF Surgery is Right For You With Citrus Spine Institute

If your back or neck pain is persistent, gets worse or is severe enough that it interferes with your daily life, it’s time to talk to a back pain specialist

At Citrus Spine Institute, our team specializes in spinal health and procedures. We will work with you to determine if you are a candidate for anterior cervical discectomy and fusion surgery, and create a treatment plan tailored to your unique condition. 

Our board-certified healthcare providers perform ACDF surgery as an outpatient procedure — meaning patients are typically able to go home the same day as their procedure. Schedule a consultation to get started.

If you are experiencing severe neck or back pain, you should never ignore or try to suffer through it. Always consult your doctor. If you are not satisfied with your doctor or require specialized care, it is recommended to get a second opinion from a spinal specialist.

Dr. Constantine Toumbis

Dr. Toumbis is a board certified, fellowship trained orthopedic surgeon specializing in cervical, thoracic and lumbar surgery. He received his undergraduate degree in Biology from New York University in 1987, then continued on to receive his Masters in Natural Sciences as well as a PhD in Experimental Pathology from State University of New York at Buffalo. He completed his medical degree at Wayne State University School of Medicine with a distinction in Biomedical Research. After moving to Florida to complete his internship and residency in orthopedics at the University of Florida Shands Hospital, he went on to pursue a fellowship at Cleveland Clinic's Florida Spine Institute. He moved to Citrus County and has been in private practice since 2005.

Subscribe to our Blog