Closed Drainage versus Non-drainage for Single-level Lumbar Discectomy: a prospective randomized controlled study [post]

2020 unpublished
In spine surgery, postoperative epidural hematoma and wound infections can have devastating neurologic compromise. Closed drainage is commonly used for prevention of postoperative hematoma, infection, and associated neurologic impairment after lumbar decompression, but it remains unclear whether closed drainage reduces postoperative complications and improves clinical outcomes or not. The purpose of this study was to determine the efficacy of closed drainage in reducing complications and
more » ... ng clinical outcomes after single-level lumbar discectomy. Methods 420 patients with single-level lumbar disc herniation were recruited between March 2012 and March 2015 (169 females and 251 males, age 50.0±6.4 years). Patients were randomly assigned to either closed drainage group (214 patients) or non-drainage group (206 patients). The rates of postoperative complications (fever, symptomatic epidural hematoma, wound infections, and requiring revision surgery) were compared between the two groups using a chi square test or Fisher exact test. Pain intensity was evaluated by VAS. Functional ability was measured for all the patients using ODI. The lower extremity VAS score and ODI score were evaluated preoperatively, postoperatively, and at the last follow-up. The operation area VAS scores were evaluated preoperative, postoperative day 1, week 1, week 2, month 1, and at the last follow-up. The scoring results were compared between the two groups using a t test. Results The difference in postoperative fever between patients in the closed drainage group (18.7%) and non-drainage group (28.2%) was statistically significant ( p <0.05). This is mainly due to the difference of patients with fever less than 38.5 °C . There was no significant difference in symptomatic epidural hematoma, infection rate, and re-operation rate when the two groups were compared. Only compared the postoperative day 1 operation area VAS score, the closed drainage group (5.1±0.8) was better than the non-drainage group (6.0±0.7) and with a significant statistical difference ( p <0.05). The left scoring results compared between the two groups were not significant difference ( p >0.05). Conclusions We believe that closed drainage can be beneficial to reduce postoperative fever rate and
doi:10.21203/rs.2.22039/v1 fatcat:umbu3yhjmbfe3mpnpmfuzdpjpu