Anterior cervical discectomy and fusion, or ACDF, is a common type of neck surgery to address pain and other symptoms caused by cervical disc problems.

See ACDF: Anterior Cervical Discectomy and Fusion and Outpatient Anterior Cervical Discectomy and Fusion (ACDF)

After an ACDF, most patients are able to go home the day of the surgery or the next day, so most of the recovery time is spent at home. This article provides a review of the typical considerations and instructions for ACDF postoperative care and rehabilitation.

See Postoperative Care for Spinal Fusion Surgery

Guidelines for ACDF Recovery

Initially, recovery after an ACDF emphasizes pain control—usually with narcotic pain medications—and walking. The patient will typically start walking the day of the surgery in order to promote healing and prevent potential complications.

See Noninvasive Pain Management Techniques

After about a week using narcotic pain relievers, the patient may shift gradually to non-narcotic pain medication, usually acetaminophen, or Tylenol. Certain pain medications should be avoided for the first several months after surgery. This includes the common NSAIDs: Non-Steroidal Anti-Inflammatory Drugs, such as aspirin, ibuprofen, naproxen, and COX-2 inhibitors.

See Medications for Back Pain and Neck Pain


In the first week at home, certain activities are restricted. For example, the patient needs to avoid turning the head sharply to the side, lifting anything heavy, and bending over. Driving must be avoided while the individual is taking narcotic pain medication or muscle relaxers. Patients are advised to move carefully, but a daily walking program is usually recommended.

See Exercise Walking for Better Back Health

While it is not the rule, sometimes the patient may be fitted with a neck brace to avoid unsafe movement and enhance stability. If this is the case, the patient will be shown how to put the brace on and take it off, and will be given instructions on how much and when to wear it.

Smoking Jeopardizes Recovery

If the individual has smoked in the past, it is vital that smoking not be resumed following surgery. Smoking, or any type of nicotine intake (including second-hand smoke), increases the risk of complications and interferes with the bone-healing process required for a successful fusion.


Activity can gradually be increased during recovery, and physical therapy is often helpful in this effort. Two to three months in physical therapy is common. In addition to offering guidance on safe ways to perform everyday tasks at home, physical therapists also can suggest ways to protect the neck before returning to work.

See Manual Physical Therapy for Pain Relief

In most cases, the fusion is set within 3 to 6 months.

See How Much Neck Mobility Is Lost After Fusion Surgery?

Dr. David DeWitt is an orthopedic surgeon practicing at the NeuroSpine Center of Wisconsin, where he specializes in spine surgery. He has more than 15 years of experience evaluating and treating spine diseases and trauma.