Subfascial Lumbar Spine Drain Output Does Not Affect Outcomes After Incidental Durotomies in Elective Spine Surgery.

OBJECTIVE: Postoperative drains have long been regarded as a preventive measure to mitigate the risks of complications such as neurological impairment by reducing hematoma formation following spine surgery. Our study aims to contribute to the existing body of knowledge by examining the impact of postoperative drain output on 90-day postoperative outcomes for patients who experienced incidental durotomies following lumbar decompression procedures, with or without fusion.

METHODS: All patients older than or equal to 18 years of age with an incidental durotomy from spinal decompression ± fusion surgery between 2017 and 2021 were retrospectively identified. Patient demographics, surgical characteristics, method of dural tear repair (Duraseal, suture, and/or Duragen), surgical outcomes, and drain data were collected via chart review. Patients were grouped based on readmission status, and final 8-hour drain output. Those with a final 8-hour drain output ≥40 mL were classified in the high drain output (HDO), while those with <40 mL were low drain output (LDO).

RESULTS: No significant differences for preoperative patient demographics, surgical characteristics, method of dural tear repair, length of stay (HDO [4.02 ± 1.90 days] vs LDO [4.26 ± 2.10], p=0.269), hospital readmissions (HDO [10.6%] versus LDO [7.96%], p=0.744), or required surgery during readmission (HDO [6.06%] versus LDO [2.65%], p=0.5944) were identified when stratifying by drain output.

CONCLUSIONS: In patients undergoing primary lumbar decompression and/or fusion with incidental durotomy, there is no significant correlation between drain output and 90-day patient outcomes. Adequate fascial closure and absence of symptoms may be satisfactory criteria for standard patient discharge.