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Is Routine Use of Drain Really Necessary for Posterior Lumbar Interbody Fusion Surgery? A Retrospective Case Series with a Historical Control Groupopen access

Authors
Jang, Hae-DongSan Park, SeongKim, KyungbumKim, Eung-HaLee, Jae ChulChoi, Sung-WooShin, Byung-Joon
Issue Date
Mar-2022
Publisher
Thieme Medical Publishers
Keywords
drain; epidural hematoma; surgical site infection; reoperation; complication; posterior lumbar interbody fusion
Citation
Global Spine Journal, v.-, no.-, pp - - -
Journal Title
Global Spine Journal
Volume
-
Number
-
Start Page
-
End Page
-
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/21615
DOI
10.1177/21925682211001801
ISSN
2192-5682
2192-5690
Abstract
Study Design: A retrospective case-control study. Objectives: The usefulness of a drain in spinal surgery has always been controversial. The purposes of this study were to determine the incidence of hematoma-related complications after posterior lumbar interbody fusion (PLIF) without a drain and to evaluate its usefulness. Methods: We included 347 consecutive patients with degenerative lumbar disease who underwent single- or double-level PLIF. The participants were divided into 2 groups by the use of a drain or not; drain group and no-drain group. Results: In 165 cases of PLIF without drain, there was neither a newly developed neurological deficit due to hematoma nor reoperation for hematoma evacuation. In the no-drain group, there were 5 (3.0%) patients who suffered from surgical site infection (SSI), all superficial, and 17 (10.3%) patients who complained of postoperative transient recurred leg pain, all treated conservatively. Days from surgery to ambulation and length of hospital stay (LOS) of the no-drain group were faster than those of the drain group (P < 0.001). In a multiple regression analysis, a drain insertion was found to have a significant effect on the delayed ambulation and increased LOS. No significant differences existed between the 2 groups in additional surgery for hematoma evacuation, or SSI. Conclusions: No hematoma-related neurological deficits or reoperations caused by epidural hematoma and SSI were observed in the no-drain group. The no-drain group did not show significantly more frequent postoperative complications than the drain use group, hence the routine insertion of a drain following PLIF should be reconsidered carefully.
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College of Medicine > Department of Orthopedic Surgery > 1. Journal Articles
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College of Medicine (Department of Orthopedic Surgery)
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