One- or Two-Level Transforaminal Lumbar Interbody Fusion without Closed-Suction Wound Drainage

Background Data: Although many surgeons stopped using closed-suction drainage following simple spine decompression surgery, there is still debate regarding the necessity of wound drainage in more extensive lumbar spine surgical procedures. Purpose: To estimate the advantages and disadvantages of pe...

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Autores principales:	Ahmed R Rizk, Andy Ottenbacher
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2019
Materias:	Transforaminal lumbar interbody fusion (TLIF) closed-suction drainage fast-track technique postoperative complications lumbar decompression and fixation Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/e72473d19fdf4d03bcf2850b65c8c1f7
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spelling	oai:doaj.org-article:e72473d19fdf4d03bcf2850b65c8c1f72021-12-02T09:52:30ZOne- or Two-Level Transforaminal Lumbar Interbody Fusion without Closed-Suction Wound Drainage10.21608/esj.2019.6618.10852314-89502314-8969https://doaj.org/article/e72473d19fdf4d03bcf2850b65c8c1f72019-04-01T00:00:00Zhttps://esj.journals.ekb.eg/article_43556_c63722034150c5a86215f48fdbd78e42.pdfhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Although many surgeons stopped using closed-suction drainage following simple spine decompression surgery, there is still debate regarding the necessity of wound drainage in more extensive lumbar spine surgical procedures. Purpose: To estimate the advantages and disadvantages of performing one- or two-level transforaminal lumbar interbody fusion (TLIF) without closed-suction drainage. Study Design: Retrospective clinical cohort study. Patients and Methods: The Fast-Track technique was performed in 36 consecutive TLIF surgeries between January and September 2016 without using wound drainage. Twenty-eight patients were females and 8 were males. Thirty patients had single-level TLIF and 6 double-level TLIF. The results of these patient series were retrospectively analyzed. The variables that were reviewed included blood transfusion, postoperative temperature, postoperative pain and the use of opiates during hospital stay, duration of surgery, duration of hospital stay, and incidence of postoperative complications such as neurological deficit, hematoma, postoperative wound infection, and revision surgery. Results: There was no postoperative allogenic blood transfusion; the patients did not develop postoperative neurological deficit; there were no cases of surgical revision as a result of significant postoperative hematoma or infection. There were two cases (5.5%) of revision surgery due to persistent CSF leakage from the wound. Four patients (11.1%) developed serous discharge from the wound, which was treated conservatively with frequent dressing and antibiotics. Four patients (11.1%) developed transient postoperative fever. The mean pain score in the first 2 days after surgery assessed by the Visual Analogue Score (VAS) was 6.1 points, and additional opiate in the first 2 postoperative days was mandatory in 30 patients (83.3%). Conclusion: Performing one- or two-level lumbar decompression and fusion without closed-suction wound drainage did not increase the rate postoperative infection or hematoma formation. Additionally, none of our patients required postoperative blood transfusion. (2018ESJ168) Ahmed R RizkAndy OttenbacherEgyptian Spine AssociationarticleTransforaminal lumbar interbody fusion (TLIF)closed-suction drainagefast-track techniquepostoperative complicationslumbar decompression and fixationNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 30, Iss 1, Pp 57-62 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Transforaminal lumbar interbody fusion (TLIF) closed-suction drainage fast-track technique postoperative complications lumbar decompression and fixation Neurology. Diseases of the nervous system RC346-429
spellingShingle	Transforaminal lumbar interbody fusion (TLIF) closed-suction drainage fast-track technique postoperative complications lumbar decompression and fixation Neurology. Diseases of the nervous system RC346-429 Ahmed R Rizk Andy Ottenbacher One- or Two-Level Transforaminal Lumbar Interbody Fusion without Closed-Suction Wound Drainage
description	Background Data: Although many surgeons stopped using closed-suction drainage following simple spine decompression surgery, there is still debate regarding the necessity of wound drainage in more extensive lumbar spine surgical procedures. Purpose: To estimate the advantages and disadvantages of performing one- or two-level transforaminal lumbar interbody fusion (TLIF) without closed-suction drainage. Study Design: Retrospective clinical cohort study. Patients and Methods: The Fast-Track technique was performed in 36 consecutive TLIF surgeries between January and September 2016 without using wound drainage. Twenty-eight patients were females and 8 were males. Thirty patients had single-level TLIF and 6 double-level TLIF. The results of these patient series were retrospectively analyzed. The variables that were reviewed included blood transfusion, postoperative temperature, postoperative pain and the use of opiates during hospital stay, duration of surgery, duration of hospital stay, and incidence of postoperative complications such as neurological deficit, hematoma, postoperative wound infection, and revision surgery. Results: There was no postoperative allogenic blood transfusion; the patients did not develop postoperative neurological deficit; there were no cases of surgical revision as a result of significant postoperative hematoma or infection. There were two cases (5.5%) of revision surgery due to persistent CSF leakage from the wound. Four patients (11.1%) developed serous discharge from the wound, which was treated conservatively with frequent dressing and antibiotics. Four patients (11.1%) developed transient postoperative fever. The mean pain score in the first 2 days after surgery assessed by the Visual Analogue Score (VAS) was 6.1 points, and additional opiate in the first 2 postoperative days was mandatory in 30 patients (83.3%). Conclusion: Performing one- or two-level lumbar decompression and fusion without closed-suction wound drainage did not increase the rate postoperative infection or hematoma formation. Additionally, none of our patients required postoperative blood transfusion. (2018ESJ168)
format	article
author	Ahmed R Rizk Andy Ottenbacher
author_facet	Ahmed R Rizk Andy Ottenbacher
author_sort	Ahmed R Rizk
title	One- or Two-Level Transforaminal Lumbar Interbody Fusion without Closed-Suction Wound Drainage
title_short	One- or Two-Level Transforaminal Lumbar Interbody Fusion without Closed-Suction Wound Drainage
title_full	One- or Two-Level Transforaminal Lumbar Interbody Fusion without Closed-Suction Wound Drainage
title_fullStr	One- or Two-Level Transforaminal Lumbar Interbody Fusion without Closed-Suction Wound Drainage
title_full_unstemmed	One- or Two-Level Transforaminal Lumbar Interbody Fusion without Closed-Suction Wound Drainage
title_sort	one- or two-level transforaminal lumbar interbody fusion without closed-suction wound drainage
publisher	Egyptian Spine Association
publishDate	2019
url	https://doaj.org/article/e72473d19fdf4d03bcf2850b65c8c1f7
work_keys_str_mv	AT ahmedrrizk oneortwoleveltransforaminallumbarinterbodyfusionwithoutclosedsuctionwounddrainage AT andyottenbacher oneortwoleveltransforaminallumbarinterbodyfusionwithoutclosedsuctionwounddrainage
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One- or Two-Level Transforaminal Lumbar Interbody Fusion without Closed-Suction Wound Drainage

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