Home Workouts May Speed Your Recovery From ACDF Surgery

Don’t let your anterior cervical discectomy and fusion be a pain in the neck.

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If you’ve never experienced chronic neck pain and radiculopathy (pain radiating down the arms) you probably know someone who has. More than 30 percent of Americans per year experience neck pain.

Anterior cervical discectomy and fusion (ACDF) is a procedure that treats these neck conditions, and it’s the most common spinal surgery performed in the U.S. It’s a great procedure, but not perfect; data suggests as many as two-thirds of patients continue to manage neck pain and dysfunction after ACDF.

Want to give yourself the best chance of a successful surgery? Get exercising.

New research suggests that starting an exercise program right after surgery may have less pain and be less reliant on opioids. A February 2020 study published in SPINE suggests that patients who began prescribed exercises right away fared better than those who started an exercise program after their six-week checkup.

ACDF home exerciseAn early home exercise program may speed ACDF recovery.

What ACDF Treats

The procedure is performed on people with degenerative disc disease or a bulging or herniated disc. These conditions can cause your spinal disc to put pressure on your spinal cord or nerve roots branching from it, creating numbness, tingling, pain, and/or weakness in one or both arms. Surgical candidates often experience symptoms that don’t respond to therapy or medication, including significant hand or arm weakness and arm pain that’s worse than neck pain.

What Is ACDF Surgery?

An ACDF procedure has two parts: a discectomy and a fusion (it’s right there in the name). “Anterior” means that the surgeon accesses your damaged discs through the front of your neck instead of the back.

Anterior approachIn an ACDF, surgeons access your cervical spine through the front of the body.

In a discectomy, a surgeon removes portions or all of an intervertebral disc to release pressure on the nerves and alleviate symptoms. Fusion marries the two vertebrae together to eliminate painful movement. Surgeons insert a bone graft between the vertebrae where the disc was removed. The bone graft acts as a structural scaffold over which the body will build new tissue and cause the vertebrae to grow together.

The graft may come from one of three sources: your own bone (called an autograft, usually a piece of bone from your pelvis- the pointy promintory of bone just above your front jean pocket), the bone donor bank (allograft, from a cadaver), or from a bone graft substitute material such as man-made plastic, ceramic, or bioresorbable compounds.

Why You Want to Start a Home Exercise Program after ACDF Surgery

Conventional wisdom holds that starting physical therapy or exercise should wait until about six weeks post-ACDF, when your recovery is well underway. However, the SPINE study suggests it may be more effective to begin a home exercise program (HEP) right away. Go ahead and put an extra emphasis on “home:” For ACDF patients, telemedicine may be a sufficient replacement for in-person physical therapy sessions, according to the study.

The study examined 28 participants’ outcomes 12 months post-operatively. Participants were divided into two groups: usual care and early HEP. Both groups received the typical postoperative care from their surgeon, plus medication, a cervical collar (neck brace) and activity restrictions.

The usual care group generally received a physical therapy referral six weeks after surgery while the early HEP group was given a self-directed HEP to perform during the initial postoperative six-weeks period. It included walking and sleeping instructions as well as range of motion and strengthening exercises. They were also given cognitive-behavioral strategies to aid in relaxation.

These participants had a weekly phone call with a physical therapist. Based on the therapist’s clinical judgment, exercises increased in difficulty every two weeks. Compared to the usual care group, the early HEP group reported decreased short-term neck pain and were less likely to be using opioids 12 months after surgery.

ACDF Recovery Tips

Recovery time after ACDF surgery generally lasts about four to six weeks. If you had a bone graft taken from your pelvis, you may experience pain, soreness, and stiffness at the incision site. To minimize discomfort, avoid sitting or lying down for long periods; change position or take a short walk every 20 minutes or so.

If your surgeon refers you to physical therapy it’s important to stay on top of your HEP; although your therapist will teach you the exercises and coach you on proper form, you need to do your “homework” consistently. It’s more effective to perform your exercises for ten minutes per day every day than 45 minutes once a week.

Home exercise ACDFStudy participants who began an exercise program sooner than six weeks had better outcomes.

It’s also important to resume your normal activities gradually. The saying “No pain, no gain” does not apply while you’re recovering from ACDF surgery. Although you might feel great on the golf course or in the swimming pool, pain and fatigue may sneak up on you the next day or the following. By gradually easing back into your activities, you can avoid major setbacks.

This doesn’t apply just to the activities we think of as exercise. Work (even if you’re sitting at a desk), grocery shopping, housework, childcare, and lawn care all fall into the category of “activity.” It can be hard to accept help, but if you have a partner, neighbor, family member, or co-worker who can relieve you of some of your duties during your recovery period, let them.

While it’s not unusual to experience a recurrence of neck pain after you’ve recovered from surgery, you can minimize discomfort by taking certain precautions.

  • Use proper form when lifting—keep loads close to your body, keep your back flat as you lift, and maintain a neutral neck position.
  • Be mindful of your posture when sitting, standing, walking, and even sleeping.
  • Gradually increase your exercise program to avoid overdoing it.
  • Address any underlying fear or anxiety; oftentimes the fear of pain causes us to tense up, thereby exacerbating or even creating pain.
  • Avoid smoking; it’s been shown to impede fusion and increase the risk of complications.

ACDF surgery is likely to improve your quality of life for years to come. While your surgeon is responsible for performing the procedure, it’s up to you to follow through with an exercise program and proper ergonomics to optimize your results.

Thinking about ACDF surgery? Find a spine specialist who can help.

Updated on: 03/30/20
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