Retrospective cohort study.

To recognize the factors that influence drain output and based on the results to formulate certain guidelines which help in deciding drain placement in patients who have undergone anterior cervical discectomy (ACD) surgeries.

The common worry of operating surgeon after anterior cervical discectomy and fusion (ACDF) surgery is postoperative neck hematoma. To avoid this, there has been a traditional practice to keep the drain postoperatively. Drain placement has got inherent complications, like infection risk, postoperative pain, increased analgesic use and increased length of hospital stay.

All patients who underwent elective ACD surgeries with surgical drain placement in our institution between from Jan 2011 and July 2014 were identified using operation theater (OT) records. Patient information was abstracted from the medical records section. Patients were categorized on the basis of normal or increased total drain output, with increased drain output defined as total drain output 50th percentile (20 ml) or more. A multivariate logistic regression was used to determine which factors were independently associated with increased drain output.

A total of 161 patients with ACDF met inclusion criteria. Total drain output was in the range from 0 to 300 ml. Among all patients in the study, 67 patients had increased drain output (drain output ≥50th percentile or 20 ml). Multivariate analysis identified three independent predictors of increased drain output: BMI, number of levels (≥2 levels) and implants.

Patients with the factors, like increased BMI, two or more level surgery and implants placed may benefit from surgical drain placement after ACD surgeries.

Patil SR, Kishan A, Gabbita A, Varadharaju DN, Jagannath PM. Anterior Cervical Surgery: Drain Needed or Not? J Spinal Surg 2015;2(2):37-41.