Pei-I Hung1,2,3, Ming-Chau Chang1,2, Po-Hsin Chou1,2, Hsi-Hsien Lin4,5, Shih-Tien Wang1,2, Chien-Lin Liu1,2. 1. Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-pai Road, 112, Taipei, 11217, Taiwan, ROC. 2. School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. 3. Department of Orthopedics and Traumatology, Taichung Veterans General Hospital, Chiayi Branch, Taiwan, ROC. 4. Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-pai Road, 112, Taipei, 11217, Taiwan, ROC. hsihsienlin@gmail.com. 5. School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. hsihsienlin@gmail.com.
Abstract
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.
RCT Entities:
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.
Entities:
Keywords:
Drain tube; Epidural haematoma; Infection; MIS TLIF; Minimally invasive surgery
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