Comparative Study of the Usage of Closed Suction and Nonsuction Drains in Cervical Laminoplasty

INTRODUCTION: Although previous studies reported the clinical significance of drains in lumbar surgery, their role in and effects on the clinical outcomes of cervical spine surgery remain unclear. The present study compared the clinical outcomes of cervical laminoplasty (CLP) using a closed suction drain (CSD) and closed nonsuction drain (CNSD). METHODS: Prospectively recorded surgical data on consecutive patients who underwent CLP at a single institution between 2014 and 2020 and were followed up for at least 1 year were examined. CSD was used prior to January 2018, and CNSD has since been employed. One hundred patients who underwent surgery before and after the change in drain type (the CSD and CNSD groups, respectively) were selected for analysis. Primary outcome measures were the drainage amount, blood count, and fluid collection at the surgical site defined by magnetic resonance images. The Japanese Orthopaedic Association (JOA) score for the cervical spine was also evaluated as a functional outcome. RESULTS: No significant differences were observed in demographic, baseline clinical, or surgical data between the CSD and CNSD groups. The drainage amount was significantly greater in the CSD group than in the CNSD group (224 vs. 143 mL, P<0.001). Hemoglobin and hematocrit levels were significantly decreased in the CSD group than in the CNSD group. Medium or large fluid collection was significantly more common in the CNSD group than in the CSD group. No significant differences were observed in the number of surgical site infections, the formation of symptomatic hematoma, or JOA scores between the two groups. CONCLUSIONS: The use of CNSD in CLP decreased the drainage amount and maintained the hemoglobin level compared with that of CSD. Although no patients developed symptomatic hematoma, the amount of epidural fluid collected was larger in the CNSD group than in the CSD group.