Are drains useful for lumbar disc surgery? A prospective, randomized clinical study

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dc.contributor.authorMirzai H.
dc.contributor.authorEminoglu M.
dc.contributor.authorOrguc Ş.
dc.date.accessioned2024-07-22T08:23:25Z
dc.date.available2024-07-22T08:23:25Z
dc.date.issued2006
dc.description.abstractOBJECTIVE: In this prospective, observer-masked clinical study, we evaluated if insertion of a drain had a significant role in decreasing the existence and the size of postoperative epidural hematoma, which is believed to be a factor causing epidural fibrosis in patients undergoing lumbar discectomy. METHOD: Fifty patients undergoing lumbar disc surgery were randomly assigned to two groups: with or without insertion of a drain in the epidural space. A drain was inserted in 22 patients, whereas 28 were left without a drain. All patients were evaluated, by means of magnetic resonance imaging (MRI) on the first postoperative day, specifically looking for the existence and the size of epidural hematoma. The size of epidural hematoma was graded as none, minimal, moderate, or prominent. The patients were clinically examined preoperatively and at the follow-up of 6 months by Oswestry Disability Index and recurrence of pain. A follow-up MRI was repeated at 6 months, and the subsequent development of epidural fibrosis was evaluated. RESULTS: Epidural hematoma was detected in 36% of patients with a drain and in 89% of patients without a drain (P=0.000). There were significant less number of minimum, moderate, and prominent sized hematomas in the group with a drain (P=0.000). On the 6-month follow-up, epidural fibrosis was found in 58.3% of patients without a drain and in 31.6% of patients with a drain (P=0.08). Late clinical outcome (improvement in Oswestry Index and no recurrent pain) was better in the group with drain, but not statistically significant (P=0.4). CONCLUSIONS: Occurrence of hematoma in the epidural space is common after lumbar disc surgery even if meticulous hemostasis has been achieved. Insertion of a drain decreases both the incidence and the size of hematoma on the first postoperative day as detected by MRI. This may have practical implications for the prevention of significant postoperative fibrosis and obtaining better surgical outcome. Copyright © 2006 by Lippincott Williams & Wilkins.
dc.identifier.DOI-ID10.1097/01.bsd.0000190560.20872.a7
dc.identifier.issn15360652
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/19530
dc.language.isoEnglish
dc.subjectAdult
dc.subjectCombined Modality Therapy
dc.subjectComorbidity
dc.subjectDrainage
dc.subjectFemale
dc.subjectHematoma, Epidural, Spinal
dc.subjectHumans
dc.subjectIntervertebral Disk Displacement
dc.subjectLaminectomy
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectPostoperative Complications
dc.subjectPrognosis
dc.subjectProspective Studies
dc.subjectRisk Assessment
dc.subjectRisk Factors
dc.subjectTreatment Outcome
dc.subjectadult
dc.subjectanalytic method
dc.subjectarticle
dc.subjectclinical article
dc.subjectclinical trial
dc.subjectcomparative study
dc.subjectcontrolled clinical trial
dc.subjectcontrolled study
dc.subjectdisability
dc.subjectepidural hematoma
dc.subjectfemale
dc.subjectfibrosis
dc.subjectfollow up
dc.subjecthemostasis
dc.subjecthuman
dc.subjectintervertebral diskectomy
dc.subjectmale
dc.subjectnuclear magnetic resonance imaging
dc.subjectoutcome assessment
dc.subjectpostoperative period
dc.subjectpriority journal
dc.subjectprospective study
dc.subjectrandomization
dc.subjectrandomized controlled trial
dc.subjectsurgical drainage
dc.subjectcomorbidity
dc.subjectintervertebral disk hernia
dc.subjectlaminectomy
dc.subjectmethodology
dc.subjectmiddle aged
dc.subjectmultimodality cancer therapy
dc.subjectpostoperative complication
dc.subjectprognosis
dc.subjectrisk assessment
dc.subjectrisk factor
dc.subjectspinal hematoma
dc.subjectstatistics
dc.subjecttreatment outcome
dc.subjectwound drainage
dc.titleAre drains useful for lumbar disc surgery? A prospective, randomized clinical study
dc.typeArticle

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