Is a drain tube necessary for minimally invasive lumbar spine fusion surgery?

• Published in: European spine journal Vol. 26; no. 3; pp. 733 - 737
• Main Authors: Hung, Pei-I, Chang, Ming-Chau, Chou, Po-Hsin, Lin, Hsi-Hsien, Wang, Shih-Tien, Liu, Chien-Lin
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2017; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Blood Loss, Surgical; Drainage - instrumentation; Female; Humans; Length of Stay; Lumbar Vertebrae - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Surgical Procedures; Neurosurgery; Operative Time; Original Article; Postoperative Care; Prospective Studies; Spinal Fusion; Surgical Orthopedics; Visual Analog Scale; Epidural haematoma; Infection; Minimally invasive surgery; MIS TLIF; Drain tube
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-016-4672-4

Purpose This study aimed to evaluate if closed suction wound drainage is necessary in minimally invasive surgery of transforaminal lumbar interbody fusion (MIS TLIF). Methods This is a prospective randomized clinical study. Fifty-six patients who underwent MIS TLIF were randomly divided into groups A (with a closed suction wound drainage) and B (without tube drainage). Surgical duration, intraoperative blood loss, timing of ambulation, length of hospital stay and complications were recorded. Patients were followed up for an average of 25.3 months. Clinical outcome was assessed using the Oswestry disability index and visual analogue scale (VAS). Fusion rate was classified with the Bridwell grading system, based on plain radiograph. Results Both groups had similar patient demographics. The use of drains had no significant influence on perioperative parameters including operative time, estimated blood loss, length of stay and complications. Patients in group B started ambulation 1 day earlier than patients in group A ( p  < 0.001). Clinical outcomes were comparable between group A and group B. Conclusion A drain tube can lead to pain, anxiety and discomfort during the postoperative period. We conclude that drain tubes are not necessary for MIS TLIF. Patients without drains had the benefit of earlier ambulation than those with drains.