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Disc Replacement Rehabilitation and Recovery

An Artificial Cervical Disc Replacement (ACDR) is a surgery performed in the neck region of the spine to remove a damaged intervertebral disc.  A damaged cervical disc is often the cause of symptoms in the neck, shoulder, and upper extremity such as pain, numbness, tingling, and/or weakness. The ACDR procedure removes the damaged disc and replaces it with an artificial disc. Artificial disc surgery is a relatively new and exciting alternative to cervical spinal fusion surgery.  Typically, when you restrict spinal motion at one segment, adjacent spinal levels will take on more stress and prematurely break down.  Advancement in ACDRs is becoming more popular because the implant allows you to maintain more natural neck motion, preserve the adjacent cervical, and allow for a better long-term success rate when compared to cervical fusion procedures.

Comparison to Cervical Fusion Rehabilitation: 

The decision for artificial disc replacement vs. cervical fusion is based on many factors and will ultimately be decided between you and your surgeon. While both have favorable outcomes, there are notable differences in rehabilitation from each.  The first few weeks after each surgery are focused on pain management and protection. The precautions of no bending, lifting or twisting will last longer after a fusion to ensure fixation of instrumentation and fusion of the bones. This leads to a longer rehabilitation period due to a slower return to normal activities. 

Timeline:

  • Post-Surgery Gentle Activity: 1-2 weeks
  • Early Rehab: 2-4 weeks
  • Return to Normal Activities: 4-6 weeks
  • Performance and Prevention: 6 weeks and beyond

Post-Surgical Rehab Starts Here

Immediately following surgery you can expect some pain and discomfort that should be well managed with medication and gentle activity. In the first 1-2 weeks be sure to follow these guidelines:

  • Adherence to post-surgical precautions
  • Avoid lifting anything heavier than a gallon of milk (8 lbs)
  • “Conversational range of motion” – less than 45 degrees left/right. A good gauge is to avoid end ranges of motion or stretching
    • WHY? It is crucial that the titanium plates adhere to the vertebrae on either side of the new disc. Excessive motion early on can interrupt this process
  • Protect incisions and manage pain/inflammation
  • Avoid staying stationary for long periods of time. This is a great time to start taking short walks.
  • Focus on healing! Stay hydrated and well nourished. Factors such as smoking and unnecessary stress may prolong healing. This is also a great time to decrease screen time and avoid “tech neck” 

Early Disc Replacement Rehabilitation: 2-4 weeks

You will begin physical therapy in the weeks following surgery depending on your surgeon’s preference. It is important to remember that each patient will have a unique timeline depending on many factors.  The goal of early rehabilitation is to reduce pain and inflammation and promote a healing environment.  You and your physical therapist will work closely to progress you appropriately. In this stage of rehabilitation, you will be working to gradually restore normal motion, gentle soft tissue techniques, initiate postural and core stability exercises, learn correct body mechanics/lifting techniques and progress your walking program. You will likely be heading back to work and starting to perform light household chores.  During this phase, you will need to “listen” to your body and avoid activities that cause an increase in your symptoms.  Cervical traction techniques should be avoided following ACDR procedures; especially mechanical traction. 

Tips:

  • Avoid compensatory strategies/postures. Your body will naturally “guard” or tense the muscles of your neck. 
    • Perform regular self check-ins to prevent returning to old habits (think: shoulders up by your ears, clenched jaw, chin poked forward, etc)
    • One perfect posture doesn’t exist – the ability to attain and maintain a variety of positions and postures while sitting or standing is optimal for a healthy spine
  • Stay moving! It is critical that you perform your home program regularly for best outcomes
    • Avoid sitting for periods of 30 minutes or more
    • Going for a walk 1-2 times per day is non-negotiable for optimal recovery 

Return to Normal Activities After Disc Replacement Surgery: 4-6 weeks

During this stage your precautions will likely be less strict as you gradually build strength and mobility in PT. The goal of this phase is to promote muscular balance and build muscular endurance, capacity, and strength to support your neck through the neck, shoulder girdle, and core.  You can expect to begin to perform moderately heavy chores and work with your physical therapist to begin a modified return to recreational activities. For example, a golfer may return to putting and short game work. Running athletes can take advantage of our Aquatic Treadmill before transitioning to a walk/jog progression.  

  • Listen to your body:
    • Avoid increases in pain more than 2 points out of 10 from your baseline level (during and after the activity)
  • Balance gradual loading: 
    • Doing too much too soon may result in setbacks in healing or excessive soreness. It is important to gradually increase exercise intensity and time spent during strenuous activities. 
    • Likewise, too little activity can delay your progress. Your body requires appropriate stress and strain to fortify the tissues surrounding your surgical site and beyond.  

Performance and Prevention: 6 Weeks and Beyond Disc Replacement Surgery

Our goal is not only to restore your general function, but to build resiliency and optimize your movement for a healthy future. The goal of this phase is to promote higher-level function across your entire body, through full body integration exercises, so you can get back to all the activities you wish to pursue.  You should expect to continue physical therapy for as long as 3 or more months after your surgery to decrease the likelihood of other injuries and get your body in better condition than your pre-injury state. Athletes and weekend warriors will transition into activity specific training with our Athletic Trainer before they return to sport or higher-level activity.  You can expect to return to impact activities around the 3 month mark.

FAQ's About Disc Replacement Recovery

Can I run after disc replacement surgery?

You and your therapist will work together to determine an appropriate return to running program after 6 weeks. Again, it is important to gradually return to running to give your body time to build endurance.

How long will I need physical therapy after disc replacement surgery?

While you can resume your normal activities around the 6 week mark, you will benefit from continued PT for 2-3 months to build up your strength and endurance. Our goal is not only to restore your general function, but to build resiliency and optimize your movement for a healthy future.

When can I swim after disc replacement surgery?

We begin utilizing the aquatic treadmill as soon as your surgical incision sites are healed. You will likely be ready to return to swimming after 6-8 weeks but it is important to verify with your doctor and physical therapist.

Can I continue physical therapy on my own after I'm cleared to get back to full activity?

Yes! We encourage you to continue performing the exercises you learned in PT after you “graduate”. Our rehab staff (PT or athletic trainer) will help you build an exercise routine that fits your goals and lifestyle.

Can athletic training help me with my physical therapy after disc replacement surgery?

Absolutely. Athletic training is not just for athletes and weekend warriors. Our athletic trainer will help you to improve your movement patterns and develop an exercise routine that fits your goals and lifestyle.