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European Spine Journal
Published in: European Spine Journal 11/2017

01-11-2017 | Review Article

The current state of the evidence for the use of drains in spinal surgery: systematic review

Authors: Salil B. Patel, William Griffiths-Jones, Conor S. Jones, Dino Samartzis, Andrew J. Clarke, Shahid Khan, Oliver M. Stokes

Published in: European Spine Journal | Issue 11/2017

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Abstract

Purpose

Search for evidence pertaining to the effectiveness of drains used in spinal surgeries.

Method

PubMed and EMBASE databases were searched for articles pertaining to the use of drains in all types of spinal surgery. The bibliographies of relevant studies were searched for additional papers that met the initial inclusion criteria. Level I and II studies were scored according to guidelines in the Cochrane Collaboration Back Review Group. We utilised the Population, Intervention, Comparison, Outcomes and Study design (PICOS) method to define our study eligibility criteria.

Results

Nineteen papers were identified: four level I studies, eight level III studies and seven level IV studies. The four level I, involving the randomization of patients into ‘drain’ and ‘non-drain’ groups, identified a total of 363 patients. Seven of the eight level III retrospective studies concluded that the use of drains did not reduce complications. Two of the seven level IV studies agreed with this conclusion. The remaining five level IV studies reported the benefits of lumbar drainage following dural tears.

Conclusions

There is a paucity of published literature on the use of drains following spinal surgery. This is the first study to assess the evidence for the benefits of drains post-operatively in spinal surgery. The identified studies have shown that drains do not reduce the incidence of complications in anterior cervical discectomy and fusion, one and two level posterior cervical fusions, lumbar laminectomies, lumbar decompressions or discectomies and posterior spinal fusion for adolescent scoliosis. Further level I and II studies are needed.
Appendix
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Metadata
Title
The current state of the evidence for the use of drains in spinal surgery: systematic review
Authors
Salil B. Patel
William Griffiths-Jones
Conor S. Jones
Dino Samartzis
Andrew J. Clarke
Shahid Khan
Oliver M. Stokes
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 11/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-017-4983-0

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