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Does Closed Wound Drainage Really Prevent Epidural Hematoma after Lumbar Surgery? Investigation Upon Postoperative Magnetic Resonance Images Noboru Hosono 1 , Takashi Kaito 2 , Takahiro Makino 1 , Yoshihiro Mukai 1 , Toshitada Miwa 1 , Takeshi Fuji 1 1Department of Orthopedic Surgery, Osaka Kosei-nenkin Hospital 2Department of Orthopaedic Surgery, National Hospital Organization Osaka Minami Medical Center Keyword: 硬膜外血腫 , spinal epidural hematoma , 合併症 , complication , ドレーン , suction drain pp.397-402
Published Date 2009/4/25
DOI https://doi.org/10.11477/mf.1408101497
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 In order to determine whether subfascial suction drains prevent epidural hematomas, 31 patients who underwent open lumbar discectomy or one-level decompression laminectomy were prospectively randomized with respect to each surgeon. The drain group (n=18) and the no-drain group (n=13) were comparable in regard to age, sex ratio, and preoperative coagulation indices. All patients underwent MRI the day after surgery and were evaluated for the presence of an epidural hematoma on axial T2-weighted images. All patients in both groups showed significant neurological improvement following surgery and there were no events suggestive of an epidural hematoma, such as intolerable pain or muscle weakness in the lower extremities. Although evidence of an asymptomatic epidural hematoma on the MRI scans was observed in a higher proportion of the patients in the drain group than in the no-drain group (54% vs. 17%), none of the patients who underwent open discectomy in either group were found to have evidence of a hematoma on their MRI scans. The results of the study suggested that suction drains are not required after open lumbar discectomy.


Copyright © 2009, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1286 印刷版ISSN 0557-0433 医学書院

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