title: Is a drain tube necessary for minimally invasive lumbar spine fusion surgery?
abstract: This study aimed to evaluate if closed suction wound drainage is necessary in minimally invasive surgery of transforaminal lumbar interbody fusion (MIS TLIF).
  
  
  
  This is a prospective randomized clinical study. Fifty-six patients who underwent MIS TLIF were randomly divided into groups A (with a closed suction wound drainage) and B (without tube drainage). Surgical duration, intraoperative blood loss, timing of ambulation, length of hospital stay and complications were recorded. Patients were followed up for an average of 25.3 months. Clinical outcome was assessed using the Oswestry disability index and visual analogue scale (VAS). Fusion rate was classified with the Bridwell grading system, based on plain radiograph.
  
  
  
  Both groups had similar patient demographics. The use of drains had no significant influence on perioperative parameters including operative time, estimated blood loss, length of stay and complications. Patients in group B started ambulation 1 day earlier than patients in group A (p < 0.001). Clinical outcomes were comparable between group A and group B.
  
  
  
  A drain tube can lead to pain, anxiety and discomfort during the postoperative period. We conclude that drain tubes are not necessary for MIS TLIF. Patients without drains had the benefit of earlier ambulation than those with drains.
authors.affiliation: Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-pai Road, 112, Taipei, 11217, Taiwan, ROC.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.|Department of Orthopedics and Traumatology, Taichung Veterans General Hospital, Chiayi Branch, Taiwan, ROC.
authors.forename: Pei-I
authors.initials: PI
authors.lastname: Hung
authors.affiliation: Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-pai Road, 112, Taipei, 11217, Taiwan, ROC.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Ming-Chau
authors.initials: MC
authors.lastname: Chang
authors.affiliation: Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-pai Road, 112, Taipei, 11217, Taiwan, ROC.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Po-Hsin
authors.initials: PH
authors.lastname: Chou
authors.affiliation: Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-pai Road, 112, Taipei, 11217, Taiwan, ROC. hsihsienlin@gmail.com.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. hsihsienlin@gmail.com.
authors.forename: Hsi-Hsien
authors.initials: HH
authors.lastname: Lin
authors.affiliation: Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-pai Road, 112, Taipei, 11217, Taiwan, ROC.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Shih-Tien
authors.initials: ST
authors.lastname: Wang
authors.affiliation: Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-pai Road, 112, Taipei, 11217, Taiwan, ROC.|School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Chien-Lin
authors.initials: CL
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D004322:Drainage / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D061646:Operative Time; D011182:Postoperative Care; D011446:Prospective Studies; D013123:Spinal Fusion; D064232:Visual Analog Scale
keywords: Drain tube; Epidural haematoma; Infection; MIS TLIF; Minimally invasive surgery