Anterior Cervical Decompression and Fusion (ACDF) Recovery

What to Expect

You’ve had anterior cervical decompression and fusion (ACDF) surgery, a first step toward the goals of decreasing neck and/or arm pain, and stopping symptoms of spinal cord compression from getting worse. Now it’s time to focus on healing. By following these tips, you will set yourself up for a successful outcome after surgery.

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Neck and back pain making things uncomfortable? Complete our Back and Neck Pain Assessment to see if it’s time to see a Norton Leatherman Spine provider.

Top 4 Things to Know

  1. Pain in the back of the neck and between the shoulder blades is common after ACDF surgery. It also is normal to have some swallowing difficulty. These usually get better over the next few weeks. If you have trouble breathing, call 911 or go to an emergency room immediately.
  2. Do not use nicotine for at least three months. Nicotine will slow down your healing.
  3. Avoid taking anti-inflammatory medications (NSAIDs) for six to 12 weeks or until your surgeon tells you it’s safe to use them. NSAIDs include ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), meloxicam (Mobic), Celebrex and diclofenac.
  4. In some cases you do not need a collar after surgery. If your surgeon gave you one, you should wear it as directed until your first follow-up appointment. Avoid excessive bending and twisting of your neck after surgery. Your surgeon will decide when your collar can come off.


If you have any trouble breathing or have excessive swelling in your neck, call 911 or go to an emergency room immediately.

Pain and Weakness

  • Neck pain, pain between the shoulder blades and a funny feeling when you swallow are normal after ACDF. These should get better over the next few weeks.
  • Numbness, tingling and weakness that you had before surgery may take time to improve.

Your Collar

  • If you were given a collar to wear, the goal of it is to keep your chin up and away from your chest. Your chin needs to be on top of the collar, not down in the collar.
  • Wear your collar until your first follow-up appointment after surgery. You may take the collar off to shower.
  • While the collar is off, keep your head as still as possible and your chin up.

Taking Care of Your Incision

  • You can take your dressing off when you get home from the hospital.
  • Underneath the dressing, you will have adhesive wound closures (Steri-strips) over your incision when you come home from the hospital. These will fall off on their own within 14 days. If they have not fallen off after 14 days, you can remove them.
  • If your incision has no drainage, it can be left uncovered after three days.


  • You can take a shower three days after surgery. Take your collar off while in the shower.
  • Avoid taking tub baths, swimming and going in hot tubs until the incision is completely healed (four to six weeks).

Taking Medication

  • Do not take anti-inflammatory medications (NSAIDS) for at least three months after surgery. These drugs can interfere with how you heal. NSAIDs include ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), meloxicam (Mobic), Celebrex and diclofenac.
  • If you need refills on your prescriptions, you may make a request through your MyNortonChart account or contact our office at least two days before you are out of pills so we have sufficient time to process your request. Refill requests on Friday afternoons and holidays likely will be addressed on the next business day.
  • Start weaning yourself from pain medications as soon as you are able. Remember, pain is a natural part of the healing process. The goal is not to eliminate all pain but to keep you comfortable as you heal. Pain medications should be used only for a short period of time.
  • Before taking Tylenol (acetaminophen), be aware that your pain medication probably has acetaminophen in it. Taking additional Tylenol or acetaminophen can put you over the daily recommended 3,000 milligrams, which can harm your liver.
  • If you are taking a muscle relaxer, one of the side effects is drowsiness. If you feel too drowsy to safely get up and move around, take the muscle relaxer less often.

Do Not Use Tobacco Products

  • If you had been a smoker or used tobacco, you were required to stop before surgery. You’ve come this far, so why not quit for good. If you cannot do so, you must not use tobacco products for at least three months. Nicotine will keep you from properly healing.

Be Active, but No Lifting

  • We want you to be active as soon as you get home from the hospital. Get up and walk often.
  • If you go up and down stairs, make sure you hold onto the railing and have someone with you.
  • Avoid bending and twisting your neck as much as you can, and do not lift anything over 10 pounds until your surgeon says it’s OK.

And No Driving

  • You cannot drive until you are no longer taking narcotic pain medications or muscle relaxers and you can move well enough to be safe behind the wheel.
  • Most patients can begin driving after the first postoperative appointment. Your surgeon will let you know when you can start driving.


  • Ice and Popsicles can help relieve a sore throat.
  • Eat soft foods that are easy to swallow. Take small bites and chew your food well. You can begin eating other foods gradually as you start to feel better.

Constipation and Bloating

  • Constipation is a common side effect of taking narcotic pain medication and a good reason to begin tapering yourself off of pain medication as soon as you can.
  • Drink lots of fluids, be active and eat foods high in fiber to help relieve constipation.
  • If constipation is bothering you, a stool softener or laxative may help. Try one of the following, and always follow the instructions: Milk of Magnesia, MiraLAX, Dulcolax suppository, Fleet enema, magnesium citrate.

When Is It an Emergency?

If you have any of the following symptoms, call 911 or go to an emergency room right away:

  • Trouble breathing
  • Chest pain
  • Excessive neck swelling
  • Significant new weakness since your surgery

If you have any other concerns, call our office at (502) 584-7525. In most cases we can help you or get you an appointment quickly.

About Norton Leatherman Spine

Norton Leatherman Spine is a combined team of orthopedic spine surgeons, neurosurgeons and pain management specialists who provide care for adults and children from Louisville and Southern Indiana, as well as from across the region, nation and world.

  • A multidisciplinary team of 45 specialists offers a comprehensive array of treatment options that include medication, pain management, rehabilitation and surgery, including minimally invasive procedures and neurosurgical therapies.
  • Norton Leatherman Spine physicians are widely renowned and exceptionally experienced, performing more than 4,000 surgeries a year.
  • Our specialists are internationally recognized leaders in clinical research of spinal disease, injury and deformity, and have served in senior positions in the Scoliosis Research Society, the most prestigious organization for scoliosis surgeons around the world.
  • Norton Healthcare is the first health system in the nation to be recognized as an Advanced Orthopedic & Spine Center of Excellence by DNV.
  • We use the EOS Imaging system, which collects high-resolution images while exposing the patient to 50% to 85% less radiation than traditional X-rays and 95% less than basic CT scans. The system is especially beneficial to scoliosis patients who often need repeated imaging to monitor their progress.
  • We accept Medicare, Medicaid and most major commercial insurance plans.
  • Use Norton MyChart to communicate with your provider, manage appointments, refill prescriptions, get alerted if an earlier appointment becomes available and more, anytime from a mobile device or computer

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