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Updated: Jul 24, 2026
Anterior Cervical Discectomy and Fusion in the Ovine Model
Published on: October 5, 2009
Are There Still Any Benefits to Drainage for Anterior Cervical Arthrodesis/Arthroplasty by Cervicotomy?
Mourad Aggad1, Louis-Marie Terrier2, Chakib Nidal Salah3
1Department of Neurosurgery, CHRU de Tours, Tours, France.
Insights
Drainage after anterior cervical spine surgery (cervicotomy) does not appear to reduce symptomatic postoperative hematoma. This study found similar hematoma rates in patients with and without drains, suggesting drains may not be beneficial.
Area of Science:
- Neurosurgery
- Spine Surgery
- Surgical Outcomes
Background:
- Anterior cervical spine surgery, including anterior cervical discectomy and fusion (ACDF) and anterior cervical disc replacement (ACDR), is a common procedure.
- The use of surgical drains during cervicotomy is debated, primarily concerning the prevention of retropharyngeal hematoma.
Purpose of the Study:
- To evaluate the effectiveness of postoperative drainage in preventing symptomatic cervical hematoma after anterior cervical spine surgery.
- To determine if surgical drains offer any benefit in the context of anterior cervicotomy.
Main Methods:
- A retrospective single-center study included 431 patients undergoing anterior cervicotomy for cervicarthrosis or cervical disc herniation between January 2019 and January 2023.
- Patients were divided into two groups: 140 patients with postoperative drainage (Group A) and 291 patients without drainage (Group B).
- The primary endpoint was the occurrence of symptomatic postoperative cervical hematoma.
Main Results:
- The overall incidence of symptomatic postoperative hematoma was 0.92% (4/431 patients).
- Two hematomas occurred in the drained group (1.4%) and two in the undrained group (0.68%), with no statistically significant difference after adjustment for confounding factors.
- One patient in each group required intervention for their hematoma.
Conclusions:
- Postoperative drainage following anterior cervicotomy for ACDF or ACDR does not limit the occurrence of symptomatic postoperative hematoma.
- The findings suggest that routine drainage may not be necessary for preventing cervical hematomas in these procedures.
Study Design:
A retrospective single-center study between January 2019 and January 2023.
Objective:
The role and contribution of drainage in the anterior approach to the cervical spine (cervicotomy) is much debated, motivated primarily by the prevention of retropharyngeal hematoma, so are there still any benefits to drainage?
Background:
The anterior approach to the cervical spine is a widespread and common procedure performed in almost all spine surgery departments for the replacement of cervical intervertebral discs and medullar or radicular decompression. The primary endpoint was the occurrence of symptomatic postoperative cervical hematoma.
Patients And Methods:
Four hundred thirty-one patients who had undergone cervical spine surgery by anterior cervicotomy for cervicarthrosis or cervical disc herniation (anterior cervical discectomy and fusion and anterior cervical disc replacement) were consecutively included. Patients were separated into 2 groups: (1) Group A, 140 patients (with postoperative drainage) and (2) Group B, 291 patients (without drainage).
Results:
The mean follow-up was 2.8 months. The 2 groups were comparable on all criteria, but there was a predominance of arthroplasty ( P < 0.0001), use of anticoagulants/antiaggregants ( P < 0.0001) and a greater number of stages ( P < 0.0001) in group A. There were a total of 4/431 symptomatic postoperative hematomas (0.92%) in this study. Two hematomas occurred in group A (2/140, 1.4%) and 2 in group B (2/291, 0.68%; P < 0.0001). One patient in group A (0.71%) required surgical drainage for cavity hematoma revealed by marked dyspnea, swallowing, and neurological disorders. One case of hematoma diagnosed by dysphonia and neurological deficit was reported in group B (0.34%; P < 0.0001).
Conclusions:
The placement of a drain during anterior cervicotomy (anterior cervical discectomy and fusion/anterior cervical disc replacement) did not limit the occurrence of symptomatic postoperative hematoma.
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