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A degenerated disc, the cushion between the bones of the spine, within the neck can lead to pressure on your spinal cord or spinal nerve roots that may require treatment to relieve symptoms.

Under these circumstances, you may need an Anterior Cervical Discectomy and Fusion (ACDF). An ACDF is a type of spine surgery used to treat neck issues by removing the damaged or herniated disc and associated bone spurs. A bone graft is placed in the space created and secured with a metal plate and screws.

The surgery is intended to improve a patient’s quality of life but eliminating the symptoms and disability associated with spinal cord and/or spinal nerve compression.

Patients may go home on the same day as their surgery or spend a night in the hospital. Once discharged, the scar from your ACDF will require some special care and attention to ensure it heals appropriately.

This article isn’t for educational purposes only, below we’re providing practical information on how to care for your ACDF surgery scar.

That said, please don’t use this as a substitute for professional medical care. Always follow the instructions of your treating surgeon or contact a medical expert for questions.

That’s enough preamble, let’s dive in!

How Big Is the Incision for ACDF Surgery?

The skin incision for your fusion surgery is usually between 1-2 inches in length, and it will be made on the left or right-hand side of your neck.

The incision is generally made at a horizontal angle within a natural skin crease. However, in some cases, vertical incisions can be made.

Caring for Your Incision and Scar at Home

To ensure your incision heals correctly, you’ll need to take appropriate precautions during your recovery.

As neck movement is limited after surgery, you may require help from a partner, friend, or family member for everyday activities.

It’s always best to consult a professional for complete, tailored advice, however, the general guidelines for caring for an ACDF incision and scar are as follows.

Keep The Incision Clean

Keep your wound clean. Several days after surgery, showering is generally permitted.

However – baths, hot tubs, and taking a dip in swimming pools can increase the risk of infection, so these should be avoided for several weeks.

For your comfort, you should avoid positioning the showerhead directly towards your incision, but it’s safe to let soapy water run over it. Incisions should be patted dry, not rubbed. Generally, no dressing is necessary to cover the adhesive strips applied during surgery.

Apply Sunscreen

Once the incision is healed, surgeons recommend applying sunscreen directly over the incision during the first year, unless you’re advised otherwise.

Sun exposure can darken scars permanently, making them more noticeable. You can look at pictures of anterior neck surgery scars to gain an idea of what your scar may look like after it’s completely healed.

How Long Does It Take For an Incision to Heal Following an ACDF?

The first few weeks after surgery are critical, and on average, your incision will take between 3-4 weeks to heal fully.

Although activities will typically not impact the healing of the incision, certain activities should be avoided so as not to disrupt the bone healing, which you won’t see. Most patients are permitted to lift up to several pounds of weight. If you have any questions, seek professional medical advice.

How Long Do You Have to Wear a Neck Brace After ACDF Surgery?

To restrict neck movement, you will be required to wear a neck brace or ‘postoperative cervical collar.

This is typically a rigid collar, made of plastic to primarily restrict forward bending, or flexion, of your neck. Depending on the surgery you’ve had, you may need to wear this collar between two to six weeks.

For example, patients who’ve had a multiple-level (3 or more) cervical fusion usually need to wear a collar for four to six weeks. In contrast, patients who’ve had a single or two-level cervical fusion may not need to wear a collar at all.

  • Single-Level Cervical Fusion: This procedure is limited to one disc and two vertebrae, or bones, of the neck.
  • Multiple-Level Cervical Fusion: This procedure involves more than one disc level.

Is ACDF Considered a Major Surgery?

ACDF surgeries are safe and incredibly successful. In fact, ACDF surgeries have an average success rate of between 73% to 100%.

However, an ACDF is still considered major surgery, and complete recovery from an ACDF procedure can take between three to six months. Bone healing may take as long as 12 months, but generally, activities are unrestricted after 3-6 months. If you have any concerns before surgery, you should talk to your spine surgeon, who can reassure you and talk you through your procedure in-depth.

ACDF Surgery Complications

While complications following an ACDF procedure are uncommon, the following is a list of potential complications that should be considered the following discharge:

  • You may develop a lump under your incision following an ACDF procedure. Generally a mild to moderate amount of swelling is normal however if larger than the size of a lemon, you should contact your surgeon. Two potential sources of such a lump are:
    • Hemorrhage or formation of a wound hematoma
    • Seroma – sterile inflammatory fluid collection
  • Swallowing difficulty – Generally, the patient will experience some swallowing difficulty following surgery. This is completely normal and a result of the surgical approach. If this prevents you from taking anything by mouth, contact your surgeon.
  • Wound infection – look for expanding redness, swelling, or drainage from the incision.

Do You Want More Info About Your Degenerative Disc Disease?

We hope you now have a better idea of how to care for the incision associated with an ACDF procedure. If you want more information about spine surgery, please feel free to contact us today.

Dr. Michael Kaiser

About Dr. Michael G. Kaiser


Dr. Michael G. Kaiser is a nationally recognized neurosurgeon in North Jersey and is a proud member of Neurosurgeons of New Jersey, practicing out of their Ridgewood office conveniently located on East Ridgewood Avenue. Dr. Kaiser specializes in complex and minimally invasive spine surgeries.

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