Effect of Absorbable Collagen Sponge and Steroid Injection for 1-or 2-Segment Anterior Cervical Discectomy and Fusion: A Retrospective Comparison Study

BACKGROUND: Dysphagia, mostly resulting from pre-vertebral soft tissue swelling (PSTS), is a common and refractory complication of anterior cervical discectomy and fusion (ACDF). Although the symptoms are mild and moderate in most cases, severe dysphagia can incur significant mental burdens and morbidity in some patients. This retrospective study aims to analyze the effect of absorbable collagen sponge and steroid injection (ACS-SI) for patients with ACDF. METHODS: A total of 150 patients in the ACS-SI group and 175 in the ACDF without absorbable collagen sponge and steroid injection (ANCS-SI) group were enrolled in this study from the Affiliated Lihuili Hospital of Ningbo University from January 2018 to November 2020. Baseline characteristics and operation parameters were collected from medical records. Swallowing function was evaluated by the Swallowing-Quality of Life (SWAL-QOL) survey, odynophagia was assessed by visual analog scale (VAS), and pre-vertebral soft tissue swelling index (PSTSI) was measured. RESULTS: There was no significant difference in baseline characteristics and operation parameters between the 2 groups. The improvement of PSTSI and recovery of swallowing function in the ACS-SI group was better than that in the ANCS-SI group at 1 day and 1-month follow-up visit (P < 0.05). The VAS score was significantly higher at 2 and 7 days after operation in the ANCS-SI group than that in the ACS-SI group (6.61 +/- 0.68 vs. 5.52 +/- 0.74 and 4.23 +/- 0.90 vs. 2.08 +/- 0.56, P < 0.05). There was no significant difference in clinical outcomes between the 2 groups after 1 month (P > 0.05). CONCLUSIONS: The use of ACS-SI is beneficial to relieve postoperative odynophagia, reduce PSTS, and recover swallow function.