Evaluation of the Use of Drain in Anterior Cervical Disc Fusion Procedures

Abstract

<i>Introduction</i>: The worldwide tendency is to minimize surgical treatments, providing lesser incisions, length of hospitalization and complications. Anterior cervical arthrodesis (ACA) is a very common procedure realized daily in many services. One of its most dread complications it’s the cervical hematoma that in severe cases need urgent evacuation and can lead to higher morbidity and even death. Despite of this is not a consensus between surgeons to use or not a drain in ACA. We retrospectively analyzed the use of a drain in patients submitted to ACA and evaluate the results of minimizing cervical collections caused by the lowest symptomatology in the post-operative period. <i>Materials and Methods</i>: Fifty-four patients submitted to ACA in one or more segments were retrospectively evaluated, through the analysis of medical records, examinations, surgical descriptions, as well the output of each drain in the postoperative period, conditions of the surgical wound (presence or not of bulging) and postoperative symptomatology (swallowing and local pain). The data obtained were submitted to statistical analysis. <i>Results</i>: 54 patients underwent ACA. The overall mean volume of cervical drain was 28.56 mL (10 - 90 ml). A direct relationship was observed between the number of levels operated and the mean drain output: 1 level=12.86 ml; 2 levels=27.88 ml; and 3 levels=32.60 ml with statistical significance (p<0.0001). In all patients, minimal or no cervical bulging, nor dysphagia was observed. <i>Conclusion</i>: We conclude that the use of the drain in ACA reduces the cervical collections, regardless of the number of segments addressed, causing less postoperative symptomatology with consequent decrease in hospitalization time, and because independent of levels we observed significant accumulation of blood we recommend that every surgeon dealing with ACA must use routinely a drain.