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Is Closed-suction Drainage Necessary for Single-level Lumbar Decompression?: Review of 560 Cases

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Closed-suction drainage is commonly used for prevention of postoperative hematoma and associated neurologic compromise after lumbar decompression, but it remains unclear whether suction drainage reduces postoperative complications.

Questions/purposes

We evaluated the efficacy of closed-suction drainage in single-level lumbar decompression surgery.

Patients and Methods

We retrospectively reviewed 560 patients who underwent single-level lumbar decompression or discectomy. We routinely used closed-suction drainage in all spinal surgeries until July 2003, and thereafter, we did not use drains in single-level lumbar decompression surgery. These two groups (298 patients in the group that received drains, 262 in the group that did not receive drains) were compared for rates of wound infection and epidural hematoma.

Results

Mean operating time (55 versus 56 minutes) and intraoperative blood loss (64 versus 57 mL) were not different between the two groups. None of 560 patients had a wound infection requiring surgical intervention. The rate of postoperative hematoma was 0.7% in the group that received drains (two of 298 patients) and 0% in the group that did not receive drains (zero of 262 patients).

Conclusions

In this study, the risk of wound infection and hematomas in single-level lumbar decompression surgery was not influenced by use of a drain. The use of postoperative wound drainage in patients with potential risk for epidural bleeding in situations such as multiple-level decompression, instrumentation surgery, anticoagulant therapy, trauma, and tumors or metastases needs additional study.

Level of Evidence

Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

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References

  1. Awad JN, Kebaish KM, Donigan J, Cohen DB, Kostuik JP. Analysis of the risk factors for the development of post-operative spinal epidural haematoma. J Bone Joint Surg Br. 2005;87:1248–1252.

    Article  CAS  PubMed  Google Scholar 

  2. Brown MD, Brookfield KF. A randomized study of closed wound suction drainage for extensive lumbar spine surgery. Spine (Phila Pa 1976) 2004;29:1066–1068.

    Google Scholar 

  3. Di Lauro L, Poli R, Bortoluzzi M, Marini G. Paresthesias after lumbar disc removal and their relationship to epidural hematoma: report of two cases. J Neurosurg. 1982;57:135–136.

    Article  CAS  PubMed  Google Scholar 

  4. Dimick JB, Lipsett PA, Kostuik JP. Spine update: antimicrobial prophylaxis in spine surgery: basic principles and recent advances. Spine (Phila Pa 1976). 2000;25:2544–2548.

    CAS  Google Scholar 

  5. Kanayama M, Hashimoto T, Shigenobu K, Oha F, Togawa D. Effective prevention of surgical site infection using a Centers for Disease Control and Prevention guideline-based antimicrobial prophylaxis in lumbar spine surgery. J Neurosurg Spine. 2007;6:327–329.

    Article  PubMed  Google Scholar 

  6. Kou J, Fischgrund J, Biddinger A, Herkowitz H. Risk factors for spinal epidural hematoma after spinal surgery. Spine (Phila Pa 1976). 2002;27:1670–1673.

    CAS  Google Scholar 

  7. Lang GJ, Richardson M, Bosse MJ, Greene K, Meyer RA Jr, Sims SH, Kellam JF. Efficacy of surgical wound drainage in orthopaedic trauma patients: a randomized prospective trial. J Orthop Trauma. 1998;12:348–350.

    Article  CAS  PubMed  Google Scholar 

  8. Lawton MT, Porter RW, Heiserman JE, Jacobowitz R, Sonntag VK, Dickman CA. Surgical management of spinal epidural hematoma: relationship between surgical timing and neurological outcome. J Neurosurg. 1995;83:1–7.

    Article  CAS  PubMed  Google Scholar 

  9. Morse K, Weight M, Molinari R. Extensive postoperative epidural hematoma after full anticoagulation: case report and review of the literature. J Spinal Cord Med. 2007;30:282–287.

    PubMed  Google Scholar 

  10. Parker MJ, Roberts CP, Hay D. Closed suction drainage for hip and knee arthroplasty: a meta-analysis. J Bone Joint Surg Am. 2004;86:1146–1152.

    Article  PubMed  Google Scholar 

  11. Payne DH, Fischgrund JS, Herkowitz HN, Barry RL, Kurz LT, Montgomery DM. Efficacy of closed wound suction drainage after single-level lumbar laminectomy. J Spinal Disord. 1996;9:401–403.

    Article  CAS  PubMed  Google Scholar 

  12. Ritter MA, Keating EM, Faris PM. Closed wound drainage in total hip or total knee replacement: a prospective, randomized study. J Bone Joint Surg Am. 1994;76:35–38.

    CAS  PubMed  Google Scholar 

  13. Scuderi GJ, Brusovanik GV, Fitzhenry LN, Vaccaro AR. Is wound drainage necessary after lumbar spinal fusion surgery? Med Sci Monit 2005;11:64–66.

    PubMed  Google Scholar 

  14. Tenney JH, Vlahov D, Salcman M, Ducker TB. Wide variation in risk of wound infection following clean neurosurgery: implications for perioperative antibiotic prophylaxis. J Neurosurg. 1985;62:243–247.

    Article  CAS  PubMed  Google Scholar 

  15. Tjeenk RM, Peeters MP, van den Ende E, Kastelein GW, Breslau PJ. Wound drainage versus non-drainage for proximal femoral fractures: a prospective randomised study. Injury. 2005;36:100–104.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan

    Masahiro Kanayama MD, Fumihiro Oha MD, Daisuke Togawa MD, Keiichi Shigenobu MD & Tomoyuki Hashimoto MD

Authors
  1. Masahiro Kanayama MD
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  2. Fumihiro Oha MD
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  3. Daisuke Togawa MD
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  4. Keiichi Shigenobu MD
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  5. Tomoyuki Hashimoto MD
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Corresponding author

Correspondence to Masahiro Kanayama MD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Kanayama, M., Oha, F., Togawa, D. et al. Is Closed-suction Drainage Necessary for Single-level Lumbar Decompression?: Review of 560 Cases. Clin Orthop Relat Res 468, 2690–2694 (2010). https://doi.org/10.1007/s11999-010-1235-6

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  • DOI: https://doi.org/10.1007/s11999-010-1235-6

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