Trial reportEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2019
Role of closed drain after multi-level posterior spinal surgery in adults: a randomised open-label superiority trial.
Trial report in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Closed-suction drainage in thoracolumbar spinal surgery-clinical routine without evidence? a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Pooled it
- Risk-benefit analysis of wound drain usage in spine surgery: a systematic review and meta-analysis with evidence summary.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020Pooled it
- Gravity-drain versus closed-suction subfascial drainage following lumbar decompression and fusion.Journal of spine surgery (Hong Kong) · 2026Article
- Evaluation of the Enhanced Recovery After Surgery (ERAS) Guidance for Patients With Spinal Metastasis.Orthopaedic surgery · 2026Review
- Blood Management and Conservation During Adult Spine Deformity Surgery.Global spine journal · 2025Article
- Review
- The safety of perioperative antiplatelet continuation without selection biases in microsurgical decompression surgery for single level lumbar spinal stenosis and lumbar disc herniotomy.Acta neurochirurgica · 2024Article
- Combined Incisional Negative Pressure Wound Therapy and Subfascial Suction Drainage: The Suction Taco Approach.Cureus · 2023Article
- Comparative study on the selection of drainage methods in posterior lumbar interbody fusion.BMC surgery · 2023Article
- Which Criterion for Wound Drain Removal is Better Following Posterior 1-Level or 2-Level Lumbar Fusion With Instrumentation: Time Driven or Output Driven?Global spine journal · 2023Article
- Effect of Drain Duration and Output on Perioperative Outcomes and Readmissions after Lumbar Spine Surgery.Asian spine journal · 2023Article
- When to remove? Evaluation of postoperative drainage volume after single-level posterior lumbar interbody fusion.Journal of orthopaedics · 2023Article
- Negative versus natural drainage after single-level posterior lumbar interbody fusion. A prospective randomized study.Brain & spine · 2023Article
- Comparative Study of the Usage of Closed Suction and Nonsuction Drains in Cervical Laminoplasty.Spine surgery and related research · 2022Article
- Lumbar surgical drains do not increase the risk of infections in patients undergoing spine surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Article
- Diagnostic performance of suction drainage fluid culture for acute surgical site infection after aseptic instrumented spine surgery: a retrospective analysis of 363 cases.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2021Observational
- Cervical laminoplasty: indication, technique, complications.Journal of spine surgery (Hong Kong) · 2020Review
- Drainage after posterior single-level instrumented lumbar fusion: Natural pressure vs negative pressure.Medicine · 2020Observational
- The Michel Benoist and Robert Mulholland yearly European spine journal review: a survey of the "surgical and research" articles in European spine journal, 2019.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo explore the role of closed suction drain in multi-level posterior spinal surgery.
methodsWe performed prospective, open-label, randomised control, superiority trial with parallel design and 1:1 allocation. A total of 161 patients undergoing posterior spinal surgery involving more than one motion segment at a dedicated spine surgery department were randomly allocated into "drain" or "no-drain" groups, based on which surgical drain was employed at the end of surgery. After excluding six cases with intraoperative dural tear, the data of 80 patients in "drain" and 75 patients in "no-drain" group were analysed. Primary outcome was total perioperative blood loss (sum of intraoperative blood loss, volume of drain if present and volume aspirated if patient developed collection in relation to surgical wound). The secondary outcomes were transfusion requirements, wound healing and complications.
resultsBoth groups were comparable with respect to baseline characteristics. Total perioperative blood loss was significantly higher in "drain" group (716 ± 312.97 ml vs 377.9 ± 295.72 ml, p < 0.0001). Number and volume of post-operative aspirations were significantly higher in "no-drain" group whereas transfusion requirements were significantly higher in "drain" group. Except for one case of superficial wound inflammation in either group, there were no complications. Subgroup analysis revealed that the results were applicable for surgeries involving "two/three" levels and "more than three" levels.
conclusionsThe practice of not using closed surgical drains after multi-level posterior spinal surgery reduces post-operative blood loss and transfusion requirements. But this comes with the disadvantage of increased wound soakage and need for post-operative wound aspirations. The risks of benefits of "drain" and "no drain" must be carefully weighed and an informed choice be taken. These slides can be retrieved under Electronic Supplementary Material.
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Registered trials
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