Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures

Rodrigues Junior Jose Carlos; Da Silva Vithor Ely Bortolin; De Campos Marcelo Ferraz

doi:doi:10.11648/j.ijn.20220601.12

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Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures

Rodrigues Junior Jose Carlos, Da Silva Vithor Ely Bortolin, De Campos Marcelo Ferraz

Published in International Journal of Neurosurgery (Volume 6, Issue 1)

Received: 20 January 2022 Accepted: 1 March 2022 Published: 9 March 2022

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Abstract

Introduction: The worldwide tendency is to minimize surgical treatments, providing lesser incisions, length of hospitalization and complications. Anterior cervical arthrodesis (ACA) is a very common procedure realized daily in many services. One of its most dread complications it’s the cervical hematoma that in severe cases need urgent evacuation and can lead to higher morbidity and even death. Despite of this is not a consensus between surgeons to use or not a drain in ACA. We retrospectively analyzed the use of a drain in patients submitted to ACA and evaluate the results of minimizing cervical collections caused by the lowest symptomatology in the post-operative period. Materials and Methods: Fifty-four patients submitted to ACA in one or more segments were retrospectively evaluated, through the analysis of medical records, examinations, surgical descriptions, as well the output of each drain in the postoperative period, conditions of the surgical wound (presence or not of bulging) and postoperative symptomatology (swallowing and local pain). The data obtained were submitted to statistical analysis. Results: 54 patients underwent ACA. The overall mean volume of cervical drain was 28.56 mL (10 - 90 ml). A direct relationship was observed between the number of levels operated and the mean drain output: 1 level=12.86 ml; 2 levels=27.88 ml; and 3 levels=32.60 ml with statistical significance (p<0.0001). In all patients, minimal or no cervical bulging, nor dysphagia was observed. Conclusion: We conclude that the use of the drain in ACA reduces the cervical collections, regardless of the number of segments addressed, causing less postoperative symptomatology with consequent decrease in hospitalization time, and because independent of levels we observed significant accumulation of blood we recommend that every surgeon dealing with ACA must use routinely a drain.

Published in	International Journal of Neurosurgery (Volume 6, Issue 1)
DOI	10.11648/j.ijn.20220601.12
Page(s)	7-10
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Cervical Disc Herniation, Anterior Approach, Drain

References

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[2]	Patel SB, Griffiths-Jones W, Jones CS, Samartzis D, Clarke AJ, Khan S, et al. The current state of the evidence for the use of drains in spinal surgery: systematic review. Eur Spine J. 2017; 26 (11): 2729–38.
[3]	von Eckardstein KL, Dohmes JE, Rohde V. Use of closed suction devices and other drains in spinal surgery: results of an online, Germany-wide questionnaire. Eur Spine J. 2016; 25 (3): 708–15.
[4]	Herrick DB, Tanenbaum JE, Mankarious M, Vallabh S, Fleischman E, Kurra S, et al. The relationship between surgical site drains and reoperation for wound-related complications following posterior cervical spine surgery: A multicenter retrospective study. J Neurosurg Spine. 2018; 29 (6): 628–34.
[5]	Epstein NE. A Review of Complication Rates for Anterior Cervical Diskectomy and Fusion (ACDF). Surg Neurol Int. 2019; 10 (100): 100.
[6]	Kelly MP, Eliasberg CD, Riley MS, Ajiboye RM, SooHoo NF. Reoperation and complications after anterior cervical discectomy and fusion and cervical disc arthroplasty: a study of 52,395 cases. Eur Spine J [Internet]. 2018; 27 (6): 1432–9. Available from: https://doi.org/10.1007/s00586-018-5570-8.
[7]	Wang T, Tian XM, Liu SK, Wang H, Zhang YZ, Ding WY. Prevalence of complications after surgery in treatment for cervical compressive myelopathy: A meta-analysis for last decade. Med (United States). 2017; 96 (12).
[8]	Poorman CE, Passias PG, Bianco KM, Boniello A, Yang S, Gerling MC. Effectiveness of postoperative wound drains in one- and two- level cervical spine fusions. Int J Spine Surg [Internet]. 2014; 8: 34. Available from: http://dx.doi.org/10.14444/1034.
[9]	Kogure K, Node Y, Tamaki T, Yamazaki M, Takumi I, Morita A. Indwelling drains are not necessary for patients undergoing one-level anterior cervical fixation surgery. J Nippon Med Sch. 2015; 82 (3): 124–9.
[10]	Lim S, Bazydlo M, Macki M, Haider S, Schultz L, Nerenz D, et al. A Matched Cohort Analysis of Drain Usage in Elective Anterior Cervical Discectomy and Fusion. Spine (Phila Pa 1976) [Internet]. 2022 Feb 1; 47 (3): 220–6. Available from: https://journals.lww.com/10.1097/BRS.0000000000004169.
[11]	Adogwa O, Khalid SI, Elsamadicy AA, Voung VD, Lilly DT, Desai SA, et al. The use of subfascial drains after multi-level anterior cervical discectomy and fusion: does the data support its use? J Spine Surg. 2018; 4 (2): 227–32.
[12]	Patil SR, Kishan A, Gabbita A, Varadharaju D, Jagannath P. Anterior Cervical Surgery: Drain Needed or Not? J Spinal Surg. 2015; 2 (2): 37–41.
[13]	Wen L, Jin D, Xie W, Li Y, Chen W, Zhang S, et al. Hidden Blood Loss in Anterior Cervical Fusion Surgery: An Analysis of Risk Factors. World Neurosurg [Internet]. 2018; 109: e625–9. Available from: https://doi.org/10.1016/j.wneu.2017.10.050.
[14]	Bertalanffy H, Eggert H-R. Complications of anterior cervical discectomy without fusion in 450 consecutive patients. Acta Neurochir (Wien) [Internet]. 1989 Mar; 99 (1–2): 41–50. Available from: http://link.springer.com/10.1007/BF01407775.
[15]	Chang VW, Lim S, Bazydlo M, Yeh H-H, Nerenz D, Abdulhak M, et al. A Matched Cohort Analysis of Drain Usage in Elective Anterior Cervical Discectomy and Fusion: A Michigan Spine Surgery Improvement Collaborative (MSSIC) Study. Neurosurgery [Internet]. 2020 Dec 1; 67 (Supplement_1): nyaa447_768. Available from: https://doi.org/10.1093/neuros/nyaa447_768.

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APA Style

Rodrigues Junior Jose Carlos, Da Silva Vithor Ely Bortolin, De Campos Marcelo Ferraz. (2022). Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures. International Journal of Neurosurgery, 6(1), 7-10. https://doi.org/10.11648/j.ijn.20220601.12

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ACS Style

Rodrigues Junior Jose Carlos; Da Silva Vithor Ely Bortolin; De Campos Marcelo Ferraz. Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures. Int. J. Neurosurg. 2022, 6(1), 7-10. doi: 10.11648/j.ijn.20220601.12

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AMA Style

Rodrigues Junior Jose Carlos, Da Silva Vithor Ely Bortolin, De Campos Marcelo Ferraz. Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures. Int J Neurosurg. 2022;6(1):7-10. doi: 10.11648/j.ijn.20220601.12

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@article{10.11648/j.ijn.20220601.12,
  author = {Rodrigues Junior Jose Carlos and Da Silva Vithor Ely Bortolin and De Campos Marcelo Ferraz},
  title = {Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures},
  journal = {International Journal of Neurosurgery},
  volume = {6},
  number = {1},
  pages = {7-10},
  doi = {10.11648/j.ijn.20220601.12},
  url = {https://doi.org/10.11648/j.ijn.20220601.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220601.12},
  abstract = {Introduction: The worldwide tendency is to minimize surgical treatments, providing lesser incisions, length of hospitalization and complications. Anterior cervical arthrodesis (ACA) is a very common procedure realized daily in many services. One of its most dread complications it’s the cervical hematoma that in severe cases need urgent evacuation and can lead to higher morbidity and even death. Despite of this is not a consensus between surgeons to use or not a drain in ACA. We retrospectively analyzed the use of a drain in patients submitted to ACA and evaluate the results of minimizing cervical collections caused by the lowest symptomatology in the post-operative period. Materials and Methods: Fifty-four patients submitted to ACA in one or more segments were retrospectively evaluated, through the analysis of medical records, examinations, surgical descriptions, as well the output of each drain in the postoperative period, conditions of the surgical wound (presence or not of bulging) and postoperative symptomatology (swallowing and local pain). The data obtained were submitted to statistical analysis. Results: 54 patients underwent ACA. The overall mean volume of cervical drain was 28.56 mL (10 - 90 ml). A direct relationship was observed between the number of levels operated and the mean drain output: 1 level=12.86 ml; 2 levels=27.88 ml; and 3 levels=32.60 ml with statistical significance (pConclusion: We conclude that the use of the drain in ACA reduces the cervical collections, regardless of the number of segments addressed, causing less postoperative symptomatology with consequent decrease in hospitalization time, and because independent of levels we observed significant accumulation of blood we recommend that every surgeon dealing with ACA must use routinely a drain.},
 year = {2022}
}

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TY  - JOUR
T1  - Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures
AU  - Rodrigues Junior Jose Carlos
AU  - Da Silva Vithor Ely Bortolin
AU  - De Campos Marcelo Ferraz
Y1  - 2022/03/09
PY  - 2022
N1  - https://doi.org/10.11648/j.ijn.20220601.12
DO  - 10.11648/j.ijn.20220601.12
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 7
EP  - 10
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20220601.12
AB  - Introduction: The worldwide tendency is to minimize surgical treatments, providing lesser incisions, length of hospitalization and complications. Anterior cervical arthrodesis (ACA) is a very common procedure realized daily in many services. One of its most dread complications it’s the cervical hematoma that in severe cases need urgent evacuation and can lead to higher morbidity and even death. Despite of this is not a consensus between surgeons to use or not a drain in ACA. We retrospectively analyzed the use of a drain in patients submitted to ACA and evaluate the results of minimizing cervical collections caused by the lowest symptomatology in the post-operative period. Materials and Methods: Fifty-four patients submitted to ACA in one or more segments were retrospectively evaluated, through the analysis of medical records, examinations, surgical descriptions, as well the output of each drain in the postoperative period, conditions of the surgical wound (presence or not of bulging) and postoperative symptomatology (swallowing and local pain). The data obtained were submitted to statistical analysis. Results: 54 patients underwent ACA. The overall mean volume of cervical drain was 28.56 mL (10 - 90 ml). A direct relationship was observed between the number of levels operated and the mean drain output: 1 level=12.86 ml; 2 levels=27.88 ml; and 3 levels=32.60 ml with statistical significance (pConclusion: We conclude that the use of the drain in ACA reduces the cervical collections, regardless of the number of segments addressed, causing less postoperative symptomatology with consequent decrease in hospitalization time, and because independent of levels we observed significant accumulation of blood we recommend that every surgeon dealing with ACA must use routinely a drain.
VL  - 6
IS  - 1
ER  -

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Author Information

Rodrigues Junior Jose Carlos

Department of Neurosurgery, Heliopolis Hospital, Sao Paulo, Brazil
Da Silva Vithor Ely Bortolin

Department of Neurosurgery, Heliopolis Hospital, Sao Paulo, Brazil
De Campos Marcelo Ferraz

Department of Neurosurgery, Heliopolis Hospital, Sao Paulo, Brazil

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APA Style

Rodrigues Junior Jose Carlos, Da Silva Vithor Ely Bortolin, De Campos Marcelo Ferraz. (2022). Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures. International Journal of Neurosurgery, 6(1), 7-10. https://doi.org/10.11648/j.ijn.20220601.12

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ACS Style

Rodrigues Junior Jose Carlos; Da Silva Vithor Ely Bortolin; De Campos Marcelo Ferraz. Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures. Int. J. Neurosurg. 2022, 6(1), 7-10. doi: 10.11648/j.ijn.20220601.12

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AMA Style

Rodrigues Junior Jose Carlos, Da Silva Vithor Ely Bortolin, De Campos Marcelo Ferraz. Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures. Int J Neurosurg. 2022;6(1):7-10. doi: 10.11648/j.ijn.20220601.12

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@article{10.11648/j.ijn.20220601.12,
  author = {Rodrigues Junior Jose Carlos and Da Silva Vithor Ely Bortolin and De Campos Marcelo Ferraz},
  title = {Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures},
  journal = {International Journal of Neurosurgery},
  volume = {6},
  number = {1},
  pages = {7-10},
  doi = {10.11648/j.ijn.20220601.12},
  url = {https://doi.org/10.11648/j.ijn.20220601.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220601.12},
  abstract = {Introduction: The worldwide tendency is to minimize surgical treatments, providing lesser incisions, length of hospitalization and complications. Anterior cervical arthrodesis (ACA) is a very common procedure realized daily in many services. One of its most dread complications it’s the cervical hematoma that in severe cases need urgent evacuation and can lead to higher morbidity and even death. Despite of this is not a consensus between surgeons to use or not a drain in ACA. We retrospectively analyzed the use of a drain in patients submitted to ACA and evaluate the results of minimizing cervical collections caused by the lowest symptomatology in the post-operative period. Materials and Methods: Fifty-four patients submitted to ACA in one or more segments were retrospectively evaluated, through the analysis of medical records, examinations, surgical descriptions, as well the output of each drain in the postoperative period, conditions of the surgical wound (presence or not of bulging) and postoperative symptomatology (swallowing and local pain). The data obtained were submitted to statistical analysis. Results: 54 patients underwent ACA. The overall mean volume of cervical drain was 28.56 mL (10 - 90 ml). A direct relationship was observed between the number of levels operated and the mean drain output: 1 level=12.86 ml; 2 levels=27.88 ml; and 3 levels=32.60 ml with statistical significance (pConclusion: We conclude that the use of the drain in ACA reduces the cervical collections, regardless of the number of segments addressed, causing less postoperative symptomatology with consequent decrease in hospitalization time, and because independent of levels we observed significant accumulation of blood we recommend that every surgeon dealing with ACA must use routinely a drain.},
 year = {2022}
}

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TY  - JOUR
T1  - Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures
AU  - Rodrigues Junior Jose Carlos
AU  - Da Silva Vithor Ely Bortolin
AU  - De Campos Marcelo Ferraz
Y1  - 2022/03/09
PY  - 2022
N1  - https://doi.org/10.11648/j.ijn.20220601.12
DO  - 10.11648/j.ijn.20220601.12
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 7
EP  - 10
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20220601.12
AB  - Introduction: The worldwide tendency is to minimize surgical treatments, providing lesser incisions, length of hospitalization and complications. Anterior cervical arthrodesis (ACA) is a very common procedure realized daily in many services. One of its most dread complications it’s the cervical hematoma that in severe cases need urgent evacuation and can lead to higher morbidity and even death. Despite of this is not a consensus between surgeons to use or not a drain in ACA. We retrospectively analyzed the use of a drain in patients submitted to ACA and evaluate the results of minimizing cervical collections caused by the lowest symptomatology in the post-operative period. Materials and Methods: Fifty-four patients submitted to ACA in one or more segments were retrospectively evaluated, through the analysis of medical records, examinations, surgical descriptions, as well the output of each drain in the postoperative period, conditions of the surgical wound (presence or not of bulging) and postoperative symptomatology (swallowing and local pain). The data obtained were submitted to statistical analysis. Results: 54 patients underwent ACA. The overall mean volume of cervical drain was 28.56 mL (10 - 90 ml). A direct relationship was observed between the number of levels operated and the mean drain output: 1 level=12.86 ml; 2 levels=27.88 ml; and 3 levels=32.60 ml with statistical significance (pConclusion: We conclude that the use of the drain in ACA reduces the cervical collections, regardless of the number of segments addressed, causing less postoperative symptomatology with consequent decrease in hospitalization time, and because independent of levels we observed significant accumulation of blood we recommend that every surgeon dealing with ACA must use routinely a drain.
VL  - 6
IS  - 1
ER  -

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