Reier Louis, Fowler James B, Arshad Mohammad, Siddiqi Javed
Neurosurgery, Desert Regional Medical Center, Palm Springs, USA.
Neurosurgery, Desert Regional Medical Center, Palm springs, USA.
Cureus. 2022 Mar 13;14(3):e23129. doi: 10.7759/cureus.23129. eCollection 2022 Mar.
No guidelines currently exist for surgeons to follow regarding drain use after spine surgery for degenerative disc disease. Therefore, we conducted a literature review to determine what situations warrant drain placement versus those which do not. When placed, we further investigate optimal drain duration. The goal of this article is to provide spine surgeons insight into the current literature and guidance when deciding if a drain should be used or discontinued. We performed a PubMed search and analyzed 44peer-reviewed journal articles. Only studies that had the full article available were included. The highest-quality studies that were reviewed, demonstrated that in most situations using a drain is not associated with superior outcomes. It revealed that when drains are retained for a longer duration they run a greater risk of surgical site infection (SSI). Additionally, drains are associated with increased blood loss, a greater chance of requiring blood transfusions, and longer hospital stays. We conclude that drains are currently being overused in spine surgery for cases of degenerative disc disease, which exposes patients to unnecessary complications while providing minimal benefit.
目前尚无关于脊柱外科医生在退行性椎间盘疾病脊柱手术后使用引流管的指导原则。因此,我们进行了一项文献综述,以确定哪些情况需要放置引流管,哪些情况不需要。当放置引流管时,我们进一步研究最佳引流持续时间。本文的目的是在脊柱外科医生决定是否应使用或停止使用引流管时,为他们提供对当前文献的见解和指导。我们在PubMed上进行了搜索,并分析了44篇经同行评审的期刊文章。仅纳入了有全文的研究。所审查的质量最高的研究表明,在大多数情况下,使用引流管与更好的结果无关。研究表明,当引流管保留时间较长时,手术部位感染(SSI)的风险更高。此外,引流管与失血增加、输血几率增加和住院时间延长有关。我们得出结论,目前在退行性椎间盘疾病的脊柱手术中引流管被过度使用,这使患者面临不必要的并发症,而获益甚微。