A Matched Cohort Analysis of Drain Usage in Elective Anterior Cervical Discectomy and Fusion

Lim, Seokchun; Bazydlo, Michael; Macki, Mohamed; Haider, Sameah; Schultz, Lonni; Nerenz, David R.; Fadel, Hassan; Pawloski, Jacob; Yeh, Hsueh‐Han; Park, Paul; Aleem, Ilyas; Khalil, Jad G.; Easton, Richard; Schwalb, Jason M.; Abdulhak, Muwaffak; Chang, Victor

doi:10.1097/brs.0000000000004169

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…demonstrated that the placement of percutaneous drainage increased the length of hospital stay [8]. Therefore, some studies argue that the use of drains would be unnecessary due to the low frequency of complications of these approaches [1,[8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures

Carlos¹,

Silva²,

Ferraz³

2022

IJN

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Introduction:The worldwide tendency is to minimize surgical treatments, providing lesser incisions, length of hospitalization and complications. Anterior cervical arthrodesis (ACA) is a very common procedure realized daily in many services. One of its most dread complications it's the cervical hematoma that in severe cases need urgent evacuation and can lead to higher morbidity and even death. Despite of this is not a consensus between surgeons to use or not a drain in ACA. We retrospectively analyzed the use of a drain in patients submitted to ACA and evaluate the results of minimizing cervical collections caused by the lowest symptomatology in the post-operative period. Materials and Methods: Fifty-four patients submitted to ACA in one or more segments were retrospectively evaluated, through the analysis of medical records, examinations, surgical descriptions, as well the output of each drain in the postoperative period, conditions of the surgical wound (presence or not of bulging) and postoperative symptomatology (swallowing and local pain). The data obtained were submitted to statistical analysis. Results: 54 patients underwent ACA. The overall mean volume of cervical drain was 28.56 mL (10 -90 ml). A direct relationship was observed between the number of levels operated and the mean drain output: 1 level=12.86 ml; 2 levels=27.88 ml; and 3 levels=32.60 ml with statistical significance (p<0.0001). In all patients, minimal or no cervical bulging, nor dysphagia was observed. Conclusion: We conclude that the use of the drain in ACA reduces the cervical collections, regardless of the number of segments addressed, causing less postoperative symptomatology with consequent decrease in hospitalization time, and because independent of levels we observed significant accumulation of blood we recommend that every surgeon dealing with ACA must use routinely a drain.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures

Carlos¹,

Silva²,

Ferraz³

2022

IJN

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The efficacy of post-operative drains for anterior cervical discectomy and fusion: a systematic review and meta-analysis

Lerch,

Chau

2023

British Journal of Neurosurgery

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Drains in Spine Surgery for Degenerative Disc Diseases: A Literature Review to Determine Its Usage

Fowler¹,

Arshad²,

Siddiqi³

2022

Cureus

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No guidelines currently exist for surgeons to follow regarding drain use after spine surgery for degenerative disc disease. Therefore, we conducted a literature review to determine what situations warrant drain placement versus those which do not. When placed, we further investigate optimal drain duration. The goal of this article is to provide spine surgeons insight into the current literature and guidance when deciding if a drain should be used or discontinued. We performed a PubMed search and analyzed 44 peer-reviewed journal articles. Only studies that had the full article available were included. The highest-quality studies that were reviewed, demonstrated that in most situations using a drain is not associated with superior outcomes. It revealed that when drains are retained for a longer duration they run a greater risk of surgical site infection (SSI). Additionally, drains are associated with increased blood loss, a greater chance of requiring blood transfusions, and longer hospital stays. We conclude that drains are currently being overused in spine surgery for cases of degenerative disc disease, which exposes patients to unnecessary complications while providing minimal benefit.

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A Matched Cohort Analysis of Drain Usage in Elective Anterior Cervical Discectomy and Fusion

Cited by 3 publications

References 26 publications

Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures

Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures

The efficacy of post-operative drains for anterior cervical discectomy and fusion: a systematic review and meta-analysis

Drains in Spine Surgery for Degenerative Disc Diseases: A Literature Review to Determine Its Usage

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