RCT Suggests Skipping Surgical Drains After Lumbar Fusion

A lovely, informative RCT on a controversial topic — but be sure your patients match these when you apply it in practice

What’s the Claim?

The latest randomized trial in the drain wars found no advantage and some disadvantages to using closed-suction drains in patients undergoing posterior lumbar decompression and fusion. It’s important to note that this study excluded patients who had dural tears noted during surgery, more than 2500 cc of intraoperative blood loss, or fusions of >3 levels. But with that caveat noted, the authors found no differences in dressing saturation, VAS pain or Oswestry disability index scores, hematocrit after surgery, or complications. They found a one-day difference favoring the no-drain group in terms of length of stay, and better quality-of-life scores (SF-36) in the no-drain group, which is somewhat difficult to explain and probably isn't important. Subanalysis of groups based on BMI found no differences in patients who were overweight or obese, either.

How’s It Stack Up?