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Closed drainage versus non-drainage for single-level lumbar discectomy: a prospective randomized controlled study
Hua Guo1, Biao Wang1, Zhaohua Ji2
1Department of Spine Surgery, Xi'an Jiaotong University College of Medicine, Honghui Hospital, Xi'an, Shaanxi, China.
BMC Musculoskeletal Disorders
|July 24, 2020
Summary
Closed drainage after lumbar discectomy may reduce low-grade fever and improve early pain relief. However, it does not significantly decrease major complications or enhance overall clinical outcomes in spinal surgery patients.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Orthopedics
Background:
- Postoperative complications like epidural hematoma and wound infection pose risks in spinal surgery.
- Closed drainage is a common preventive measure after lumbar decompression.
- The efficacy of closed drainage in reducing complications and improving outcomes remains unclear.
Purpose of the Study:
- To investigate the role of closed drainage in minimizing postoperative complications.
- To evaluate the impact of closed drainage on clinical efficacy after single-level lumbar discectomy.
- To compare complication rates and functional recovery between drainage and non-drainage groups.
Main Methods:
- A randomized controlled trial involving 420 patients undergoing single-level lumbar discectomy.
- Patients were allocated to either a closed drainage group (214) or a non-drainage group (206).
- Outcomes assessed included postoperative fever, symptomatic epidural hematoma, wound infection, revision surgery rates, Visual Analogue Scale (VAS) pain scores, and Oswestry Disability Index (ODI).
Main Results:
- A statistically significant difference was observed in the postoperative fever rate (p=0.022), with the non-drainage group experiencing higher rates.
- No significant differences were found in symptomatic epidural hematoma, wound infection, or revision surgery rates between the groups (p>0.05).
- The closed drainage group showed significantly better pain relief in the operation area on postoperative day one (VAS scores: 5.1 vs. 6.0, p<0.001), but no significant differences in other pain or functional scores.
Conclusions:
- Closed drainage may help reduce low-grade postoperative fever and improve early incisional pain after single-level lumbar discectomy.
- Drainage did not demonstrate a significant impact on reducing major postoperative complications such as epidural hematoma or wound infection.
- The study suggests limited benefits of closed drainage for overall clinical efficacy in this patient population.
