Improved Intermittent-clamped Drainage in Lower Lumbar Internal Fixation: A Randomized Prospective Study

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Surgical Drainage Techniques

Background:

• Continuous negative pressure drainage (CNPD) is standard after lower lumbar internal fixation but can cause significant blood loss and anemia.
• An improved intermittent-clamped drainage (ICD) method is proposed to mitigate these risks.

Purpose of the Study:

• To evaluate the efficacy and safety of the improved intermittent-clamped drainage (ICD) technique.
• To compare postoperative drainage volume and complications between ICD and CNPD in lower lumbar internal fixation.

Main Methods:

• A prospective study involving 156 patients undergoing spinal canal decompression and internal fixation.
• Patients were randomized into two groups: ICD (78 patients) and CNPD (78 patients).
• Postoperative drainage amount, hemoglobin levels, and complications were recorded and analyzed using statistical tests (Shapiro-Wilk, t-test, Mann-Whitney U).

Main Results:

• The ICD group showed a statistically significant reduction in postoperative drainage volume compared to the CNPD group (P < 0.01).
• Mean total drainage was significantly lower in the ICD group for both single-segment and two-segment procedures.
• No significant differences were observed in postoperative temperature, wound issues, or overall complications between the groups.

Conclusions:

• Improved intermittent-clamped drainage (ICD) is an effective, convenient, and safe alternative to CNPD for lower lumbar surgery.
• ICD significantly reduces postoperative blood loss and is suitable for routine clinical application.
• Further research should investigate ICD's impact on long-segment procedures, complex lumbar diseases, and long-term functional outcomes.