Preparing for your surgery

by Sarah Middleton, RN, BSN, Joint & Spine Center Coordinator

Hi, welcome to the page that is all about anterior cervical neck fusions (ACDF). I want to prepare you and your partner or coach that will be helping you after surgery a little bit about what you may experience after this surgery so you will be prepared. The purpose of this page is to give you a few important highlights that may not have been discussed at your pre-op appointment with your Surgeon but is common after this surgery, will help you manage your pain faster and get the best outcome after your anterior neck surgery!

After surgery you will probably either be issued a soft collar which is an “optional” option to wear the collar or a hard collar which is to wear at all times except when in bed or in the shower. Please note, even if you have a soft collar on, you should NOT tilt your head from front to back, twist or move your neck quickly until your Surgeon states otherwise which could be weeks or months so if you have a hard time keeping your head aligned it is best to plan to keep that soft collar on at all times. Think about how you are going to brush your teeth, reach for certain things if you cannot move your neck/head. Moving things around your house before surgery is helpful and having a grabber or reacher will be beneficial.

Also after surgery you will have to plan on sleeping at least a 45-degree angle or higher so have a foam wedge pillow on your bed or pillows propped up, find a recliner that keeps your head elevated or find a comfortable piece of furniture that keeps your head elevated for the next 5-10 days when sleeping or resting until your Surgeon tells you it is okay to lay flat again.

After your anterior neck surgery

You may experience increased swelling in your neck or incisional area over the next three to four days after your surgery. This is normal and it will not cause you to have shortness of breath. If you experience this, this is a 9-1-1 situation. Typically, you may not notice this the day of your surgery or the day after your surgery but the next day (post-op day #2) is when most patients start to feel tightness around the incision area and complain that food and pills start to catch when they attempt to swallow. Over the next few days as the swelling increases, it may cause difficulty when trying to eat or drink and swallow your pills. The most difficult food to eat may be meat products due to the tough texture, so please steer clear until the swelling goes down. Typically, after a week or earlier you will notice the swelling start to dissipate. Be sure to take your time and chew your food thoroughly before swallowing. Foods that may be easier to eat after your surgery are thinner in consistency such as creamy soups, smoothies, yogurts, ice creams and applesauce. Cutting your pain pills in half may make it easier to get down if you need to after your surgery. Tucking your chin down half an inch into your neck collar, if your surgeon prescribed one after surgery may help as well. Make sure you are sitting up at a 90 degree angle and not leaning back when eating or drinking. Elevating your head above your heart, in other words, keeping upright will decrease these difficulties if they occur after your surgery.

It is not uncommon to experience a dry or sore throat for a week to two weeks after this surgery. Throat lozenges or sucking on ice chips may help. Some patients prefer warm liquids to soothe their sore throat. Even though it is painful after surgery, it is important to make sure you are taking full deep breaths and working on coughing and clearing any secretions after surgery.

It is common for patients to experience shoulder or muscle pain in the back of their shoulder and down one side of their neck after their anterior neck surgery. This will ease up in a week or two after surgery as well. Things that help with this include but are not limited to; propping your arms on pillows when you are sitting in a chair or laying in bed at a reclined 45 degree angle or higher. By propping your arms on pillows you are allowing those muscles to rest and not be stretched more when sitting. Using ice packs to your shoulders or heat packs are great as well. If you do find heat more comfortable to your shoulders, just make sure that you have an ice pack applied under your incision below your neck brace the first week after surgery to help with the increased swelling in your surgical site. Moving your shoulders and arms around will help as well.

The last trick that is very simple and has many benefits after surgery is just getting up and walking at least every hour during the day that you are awake. The first week after surgery, we recommend at least five (5) minutes every hour and then increase your walking as you can tolerate. Not only is it going to be your only prescribed Physical Therapy after surgery for the next three (3) months or so but it will also help decrease the surgical site swelling, help keep things moving and prevent complications after surgery like pneumonia and blood clots. Make sure that if your Surgeon has prescribed a hard or soft neck collar that you wear it all the times unless your Surgeon tells you otherwise. While you are wearing this neck collar you are allowing your neck to heal and it is to remind you not to twist your neck, move your head. Pretend your body is a log, if you want to look at something or move turn your feet in the direction you want to look, not your head or neck.

I hope you learned something beneficial that will help you after your upcoming surgery and we look forward to taking care of you here at Capital Medical Center. Our goal is to provide you with top-quality care. Please let us know if there is anything we can do to assist you while you are here!

Best Wishes!



Sarah Middleton RN, BSN
Joint & Spine Coordinator
Capital Medical Center