@djliang Hello and welcome to Connect. I am a cervical spine fusion patient, and yes, the first 2-3 weeks after ACDF cause throat pain and some difficulty swallowing. Some of that could also be from intubation. That resolved for the most part. It has been 7 years, and I can feel some tightness in my throat on that side, and it just feels different. Right after surgery, it is like one half of your throat forgets how to swallow and you can easily swallow wrong, so you have to be focused and not try to talk and eat at the same time. The tightness of surgical scar tissue can affect the area, and it was stretched during surgery by being retracted to get behind the esophagus. It is a risk that is can cause a permanent issue. They can also do a fusion from the back side and it may not have the same risks, but that is something to ask about. Depending on where the issues are, the surgeon has to choose the best path to be able to get there, and not all surgery can be done minimally invasive. For example, I had bone spurs inside the spinal canal pressing into my spinal cord. That could not be done as minimally invasive. The disc has to be removed to access the spinal canal through its leftover space. Another risk is vocal cord paralysis, and there are procedures to address that by placing an implant so a floppy cord can match it's partner to be able to vocalize again. Not all hospitals may have that procedure available, but Mayo does this surgery.

What does help the surgeon is if your neck muscles are not so tight. I asked, and my surgeon showed me how to use my hand to stretch my neck skin where his incision would be. I also work with a physical therapist and stretch tight areas on my neck and shoulders. I still have to do this because a surgical scar periodically tightens up, so that is kind of regular maintenance for me.

There is a risk to every surgery, and you have to discuss in detail what your best option is and how that relates to your condition. People who use their voice for a living as singers also go through this surgery, and the surgeons take as many precautions as they can. You may want to ask about that, and if you can work with a physical therapist ahead of time to prepare. My surgeon said if he was to do a second cervical surgery, he would operate through the back to avoid adding more scar tissue to an already operated area.