Is Closed-Suction Drainage Essential after Minimally Invasive Lumbar Fusion Surgery?: A Retrospective Review of 381 Cases
Objective Closed suction drains have been widely used after lumbar fusion surgeries but with controversial evidence. The recent advances in the minimally invasive spine surgeries (MIS) lead to smaller dead space, lesser blood loss and fewer infections. With these touted advantages the drains may not...
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| Format: | Article |
| Language: | English |
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Korean Minimally Invasive Spine Surgery Society
2017-06-01
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| Series: | Journal of Minimally Invasive Spine Surgery and Technique |
| Subjects: | |
| Online Access: | http://www.jmisst.org/upload/pdf/jmisst-2017-00185.pdf |
| _version_ | 1797951548260614144 |
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| author | Arvind Gopalrao Kulkarni Ravish Shammi Patel |
| author_facet | Arvind Gopalrao Kulkarni Ravish Shammi Patel |
| author_sort | Arvind Gopalrao Kulkarni |
| collection | DOAJ |
| description | Objective Closed suction drains have been widely used after lumbar fusion surgeries but with controversial evidence. The recent advances in the minimally invasive spine surgeries (MIS) lead to smaller dead space, lesser blood loss and fewer infections. With these touted advantages the drains may not be necessary. Our study was aimed to evaluate the outcomes of MIS lumbar fusions without closed-suction drains. Methods A retrospective review was conducted between June 2007 and January 2016. Patients that underwent MIS transforaminal lumbar interbody fusion (TLIFs) without postoperative drainage were enrolled. Patients with more than 12 months of follow-up were selected. Perioperative variables and clinical outcomes were analysed from the medical records. Incidences of infection and postoperative epidural hematoma were evaluated. Results Out of 381 patients, there were 341 patients that underwent one-level fusion and 40 patients had two-level fusions. The mean operative time was 218 minutes (range: 150-348 minutes) per level, mean blood loss was 125 mL per level (range: 80-190 mL) and mean hospital stay was 5 days (range: 4-14 days). Visual Analogue Scale (VAS) leg, VAS back and Oswestry Disability Index (ODI) scores improved by 70.6%, 58.6% and 57.4% respectively. Three patients had infections and one patient developed postoperative epidural hematoma requiring surgical intervention. The infection rate was 0.78% and the incidence of postoperative epidural hematoma with the neurological deficit was 0.26%. Conclusion MIS-TLIFs without a postoperative closed-suction drain showed favourable outcomes. There was no evidence of an increase in the rate of infection or increase in rate of symptomatic postoperative epidural hematoma in patients undergoing MIS-TILFs without a postoperative closed-suction drain. |
| first_indexed | 2024-04-10T22:32:19Z |
| format | Article |
| id | doaj.art-cb7df25919854a968b4d87f9336a3ed2 |
| institution | Directory Open Access Journal |
| issn | 2508-2043 |
| language | English |
| last_indexed | 2024-04-10T22:32:19Z |
| publishDate | 2017-06-01 |
| publisher | Korean Minimally Invasive Spine Surgery Society |
| record_format | Article |
| series | Journal of Minimally Invasive Spine Surgery and Technique |
| spelling | doaj.art-cb7df25919854a968b4d87f9336a3ed22023-01-17T04:09:23ZengKorean Minimally Invasive Spine Surgery SocietyJournal of Minimally Invasive Spine Surgery and Technique2508-20432017-06-0121273110.21182/jmisst.2017.0018528Is Closed-Suction Drainage Essential after Minimally Invasive Lumbar Fusion Surgery?: A Retrospective Review of 381 CasesArvind Gopalrao Kulkarni0Ravish Shammi Patel1 Consultant Spine Surgeon, Bombay Hospital and Medical Research Center, Mumbai, India Spine Fellow, Bombay Hospital and Medical Research Center, Mumbai, IndiaObjective Closed suction drains have been widely used after lumbar fusion surgeries but with controversial evidence. The recent advances in the minimally invasive spine surgeries (MIS) lead to smaller dead space, lesser blood loss and fewer infections. With these touted advantages the drains may not be necessary. Our study was aimed to evaluate the outcomes of MIS lumbar fusions without closed-suction drains. Methods A retrospective review was conducted between June 2007 and January 2016. Patients that underwent MIS transforaminal lumbar interbody fusion (TLIFs) without postoperative drainage were enrolled. Patients with more than 12 months of follow-up were selected. Perioperative variables and clinical outcomes were analysed from the medical records. Incidences of infection and postoperative epidural hematoma were evaluated. Results Out of 381 patients, there were 341 patients that underwent one-level fusion and 40 patients had two-level fusions. The mean operative time was 218 minutes (range: 150-348 minutes) per level, mean blood loss was 125 mL per level (range: 80-190 mL) and mean hospital stay was 5 days (range: 4-14 days). Visual Analogue Scale (VAS) leg, VAS back and Oswestry Disability Index (ODI) scores improved by 70.6%, 58.6% and 57.4% respectively. Three patients had infections and one patient developed postoperative epidural hematoma requiring surgical intervention. The infection rate was 0.78% and the incidence of postoperative epidural hematoma with the neurological deficit was 0.26%. Conclusion MIS-TLIFs without a postoperative closed-suction drain showed favourable outcomes. There was no evidence of an increase in the rate of infection or increase in rate of symptomatic postoperative epidural hematoma in patients undergoing MIS-TILFs without a postoperative closed-suction drain.http://www.jmisst.org/upload/pdf/jmisst-2017-00185.pdfspinelumbararthrodesisminimally invasive surgical procedurescomplicationsinfectionsepidural hematoma |
| spellingShingle | Arvind Gopalrao Kulkarni Ravish Shammi Patel Is Closed-Suction Drainage Essential after Minimally Invasive Lumbar Fusion Surgery?: A Retrospective Review of 381 Cases Journal of Minimally Invasive Spine Surgery and Technique spine lumbar arthrodesis minimally invasive surgical procedures complications infections epidural hematoma |
| title | Is Closed-Suction Drainage Essential after Minimally Invasive Lumbar Fusion Surgery?: A Retrospective Review of 381 Cases |
| title_full | Is Closed-Suction Drainage Essential after Minimally Invasive Lumbar Fusion Surgery?: A Retrospective Review of 381 Cases |
| title_fullStr | Is Closed-Suction Drainage Essential after Minimally Invasive Lumbar Fusion Surgery?: A Retrospective Review of 381 Cases |
| title_full_unstemmed | Is Closed-Suction Drainage Essential after Minimally Invasive Lumbar Fusion Surgery?: A Retrospective Review of 381 Cases |
| title_short | Is Closed-Suction Drainage Essential after Minimally Invasive Lumbar Fusion Surgery?: A Retrospective Review of 381 Cases |
| title_sort | is closed suction drainage essential after minimally invasive lumbar fusion surgery a retrospective review of 381 cases |
| topic | spine lumbar arthrodesis minimally invasive surgical procedures complications infections epidural hematoma |
| url | http://www.jmisst.org/upload/pdf/jmisst-2017-00185.pdf |
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