At home you are able to be active as you can. The physiotherapist would have demonstrated some simple movement exercises for the neck and I encourage you to walk for exercise. The stitches are beneath your skin and hence do not need to be taken out. The dressing on the wound should be left in place for three or four days. It can then be removed. You can get your wound wet, just make sure you dry it. We usually organise for you to have a review appointment around six weeks after your surgery with an x-ray. You are able to drive when your pain has settled enough such that you have a reasonable range of movement in your neck and you are happy you can safely control a car. You are able to return to work when you feel comfortable enough to do so.
Following surgery, a number of patients will have some discomfort or awkward feeling swallowing for some time. This is consequent to the surgical approach. It usually settles over time.
As with any surgical procedure there are potential risks and complications which fortunately are infrequent. The risks and complications relevant to Anterior Cervical Discectomy and Fusion are;
From this sort of surgery it is exceedingly rare. Should you develop infection, treatment would range from requiring simple antibiotics through to needing further surgery to clean the infection out.
COMPLICATIONS RELATING TO SURGICAL ACCESS
As above, the approach to access the spine runs between the artery and vein going to and coming from the brain (carotid neurovascular bundle) as well as your wind pipe (trachea) and gullet (esophagus). This space is usually easy to access. Rarely, any of these structures could be damaged in the approach. This could cause stroke, breathing difficulties or infection. There is a nerve that runs down with the artery and vein and comes back up with the trachea and esophagus which goes to the voice box. Some times this nerve can be stretched leaving you with some hoarseness of voice which usually recovers. Rarely is the nerve permanently damaged leading to permanent hoarseness of the voice. Coincidentally it is this nerve that Neville Wran had damaged during an operation on his neck.
SPINAL CORD / NERVE INJURY
The purpose of the surgery is to remove pressure on the spinal cord or nerves and obviously involves working around these structures. It is possible that they can be damaged during the surgery. The worst case scenario is this could lead to quadriplegia or possible nerve damage which could result in pain, weakness or numbness in the distribution of the injured nerve. Such complications are very unusual from this type of surgery. It is possible that post operatively there could be significant bleeding around the spinal cord or nerve (epidural hematoma). Should progressive nerve defect develop after surgery this may require emergency surgical drainage.
INSTRUMENTATION MALPOSITION / FAILURE
It is possible that the implants can be incorrectly placed and this can cause damage to the spinal cord or nerves. Again this is highly unusual. On occasions the implant can sink into the bone if it is not strong enough. This may require further surgery.
The operation is designed to fuse two adjacent vertebra. The fusion rate for a single level operation should be in the region of 95 or 96%. If the vertebra do not fuse together and you have limited in the way of symptoms, this is of no consequence. Occasionally failure to fuse (pseudarthrosis) is associated with significant pain in which case further surgery can be undertaken. This usually involves placement of some screws across the same levels at the back of the spine. Occasionally it may involve re-doing the surgery from the front of the neck.
There are a variety of medical complications which can occur with major surgical procedures. The likelihood that these will occur to some extent is determined by your health before surgery and past medical history. Fortunately with modern anaesthesia and perioperative care, medical risks involved in elective surgery are comparatively low. Common surgical complications such as deep venous thrombosis, pulmonary embolism, pneumonia, urinary tract infection and skin pressure areas that are best avoided with early mobilisation.