title: The current state of the evidence for the use of drains in spinal surgery: systematic review.
abstract: Search for evidence pertaining to the effectiveness of drains used in spinal surgeries.
  
  
  
  PubMed and EMBASE databases were searched for articles pertaining to the use of drains in all types of spinal surgery. The bibliographies of relevant studies were searched for additional papers that met the initial inclusion criteria. Level I and II studies were scored according to guidelines in the Cochrane Collaboration Back Review Group. We utilised the Population, Intervention, Comparison, Outcomes and Study design (PICOS) method to define our study eligibility criteria.
  
  
  
  Nineteen papers were identified: four level I studies, eight level III studies and seven level IV studies. The four level I, involving the randomization of patients into 'drain' and 'non-drain' groups, identified a total of 363 patients. Seven of the eight level III retrospective studies concluded that the use of drains did not reduce complications. Two of the seven level IV studies agreed with this conclusion. The remaining five level IV studies reported the benefits of lumbar drainage following dural tears.
  
  
  
  There is a paucity of published literature on the use of drains following spinal surgery. This is the first study to assess the evidence for the benefits of drains post-operatively in spinal surgery. The identified studies have shown that drains do not reduce the incidence of complications in anterior cervical discectomy and fusion, one and two level posterior cervical fusions, lumbar laminectomies, lumbar decompressions or discectomies and posterior spinal fusion for adolescent scoliosis. Further level I and II studies are needed.
authors.affiliation: Exeter Spine Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK.|Peninsula College of Medicine and Dentistry, Barrack Road, Exeter, EX2 5DW, UK.
authors.forename: Salil B
authors.initials: SB
authors.lastname: Patel
authors.affiliation: Exeter Spine Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK.
authors.forename: William
authors.initials: W
authors.lastname: Griffiths-Jones
authors.affiliation: Exeter Spine Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK.|Peninsula College of Medicine and Dentistry, Barrack Road, Exeter, EX2 5DW, UK.
authors.forename: Conor S
authors.initials: CS
authors.lastname: Jones
authors.affiliation: Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China.
authors.forename: Dino
authors.initials: D
authors.lastname: Samartzis
authors.affiliation: Exeter Spine Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Clarke
authors.affiliation: Exeter Spine Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK.
authors.forename: Shahid
authors.initials: S
authors.lastname: Khan
authors.affiliation: Exeter Spine Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK. oliverstokes@hotmail.com.
authors.forename: Oliver M
authors.initials: OM
authors.lastname: Stokes
mesh_terms: D004322:Drainage / Q000706:statistics & numerical data*; D006801:Humans; D019637:Orthopedic Procedures / Q000379:methods / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D013131:Spine / Q000601:surgery*
keywords: Drains; Dura; Paediatric; Review; Spine surgery