Effect of Reprocessed Micronized Acellular Dermal Matrix on Postoperative Dysphagia After Anterior Cervical Discectomy and Fusion: A Propensity Score-Matched Study

Background and Objectives: Postoperative dysphagia following anterior cervical discectomy and fusion (ACDF) remains a common complication affecting patient quality of life. This study evaluated the safety and clinical efficacy of reprocessed micronized acellular dermal matrix (ADM) compared to conventional gel-type anti-adhesive agents in patients undergoing single-level ACDF. Materials and Methods: This retrospective propensity score-matched study included 108 patients (54 matched pairs) who underwent single-level ACDF between January 2021 and December 2025. The ADM group received CGDerm Matrix™ and the control group received Mediclore™. The primary outcome was postoperative swallowing function assessed by the Swallowing Impairment Score (SIS-6) at 3 months (pre-specified primary time point). Secondary outcomes included VAS, NDI, modified MacNab criteria, adhesion scores, prevertebral soft tissue swelling, and perioperative inflammatory markers. Bonferroni correction was applied for multiple comparisons (adjusted α = 0.0125). Results: The ADM group demonstrated significantly lower SIS-6 scores at 3 months (0.26 ± 0.16 vs. 0.68 ± 0.27, p = 0.01), which remained significant after Bonferroni correction. All other clinical and radiological outcomes were comparable between groups. No device-related complications occurred. Conclusions: ADM application in ACDF surgery appears safe and is associated with improved postoperative swallowing function at 3 months. However, the clinical significance of observed differences requires further investigation.