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Subfascial Lumbar Spine Drain Output Does Not Affect Outcomes After Incidental Durotomies in Elective Spine Surgery – Lumbar Spinal Stenosis

The article investigates the impact of postoperative drain output on 90-day postoperative outcomes for patients who experienced incidental durotomies following lumbar decompression procedures, with or without fusion. The study conducted a retrospective analysis of patients between 2017 and 2021 and collected data on patient demographics, surgical characteristics, dural tear repair methods, surgical outcomes, and drain data. Patients were categorized into high drain output (HDO) or low drain output (LDO) groups based on their final 8-hour drain output. The results showed no significant differences in patient outcomes or readmission rates between the two groups, suggesting that drain output may not be correlated with 90-day patient outcomes. The study suggests that adequate fascial closure and absence of symptoms may be sufficient criteria for patient discharge

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spinal hospital on Harley Street UK

Published article

CONCLUSIONS: In patients undergoing primary lumbar decompression and/or fusion with incidental durotomy, there is no significant correlation between drain output and 90-day patient outcomes. Adequate fascial closure and absence of symptoms may be satisfactory criteria for standard patient discharge.

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World Neurosurg. 2023 Oct 25:S1878-8750(23)01507-3. doi: 10.1016/j.wneu.2023.10.100. Online ahead of print.ABSTRACTOBJECTIVE: Postoperative drains have long been regarded as a preventive measure to mitigate the risks of complications such as neurological impairment by reducing hematoma formation following spine surgery. Our study aims to contribute to the existing body of knowledge by examining the impact of postoperative,

World Neurosurg. 2023 Oct 25:S1878-8750(23)01507-3. doi: 10.1016/j.wneu.2023.10.100. Online ahead of print.

ABSTRACT

OBJECTIVE: Postoperative drains have long been regarded as a preventive measure to mitigate the risks of complications such as neurological impairment by reducing hematoma formation following spine surgery. Our study aims to contribute to the existing body of knowledge by examining the impact of postoperative drain output on 90-day postoperative outcomes for patients who experienced incidental durotomies following lumbar decompression procedures, with or without fusion.

METHODS: All patients older than or equal to 18 years of age with an incidental durotomy from spinal decompression ± fusion surgery between 2017 and 2021 were retrospectively identified. Patient demographics, surgical characteristics, method of dural tear repair (Duraseal, suture, and/or Duragen), surgical outcomes, and drain data were collected via chart review. Patients were grouped based on readmission status, and final 8-hour drain output. Those with a final 8-hour drain output ≥40 mL were classified in the high drain output (HDO), while those with <40 mL were low drain output (LDO).

RESULTS: No significant differences for preoperative patient demographics, surgical characteristics, method of dural tear repair, length of stay (HDO [4.02 ± 1.90 days] vs LDO [4.26 ± 2.10], p=0.269), hospital readmissions (HDO [10.6%] versus LDO [7.96%], p=0.744), or required surgery during readmission (HDO [6.06%] versus LDO [2.65%], p=0.5944) were identified when stratifying by drain output.

CONCLUSIONS: In patients undergoing primary lumbar decompression and/or fusion with incidental durotomy, there is no significant correlation between drain output and 90-day patient outcomes. Adequate fascial closure and absence of symptoms may be satisfactory criteria for standard patient discharge.

PMID:37890770 | DOI:10.1016/j.wneu.2023.10.100

The London Spine Unit : top spinal hospital on Harley Street UK

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Subfascial Lumbar Spine Drain Output Does Not Affect Outcomes After Incidental Durotomies in Elective Spine Surgery

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World Neurosurg. 2023 Oct 25:S1878-8750(23)01507-3. doi: 10.1016/j.wneu.2023.10.100. Online ahead of print.ABSTRACTOBJECTIVE: Postoperative drains have long been regarded as a preventive measure to mitigate the risks of complications such as neurological impairment by reducing hematoma formation following spine surgery. Our study aims to contribute to the existing body of knowledge by examining the impact of postoperative

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