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Natural pressure drainage versus negative pressure drainage following transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar degeneration disease: a prospective cohort study

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Objective

To comprehensively compare the perioperative data and clinical outcomes of natural pressure drainage (NAPD) and negative pressure drainage (NEPD) following transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar degeneration disease.

Methods

Between January 2021 and December 2021, 203 patients in our hospital who underwent single- or two-segment TLIF were assigned to the NAPD group (112 patients) or the NEPD group (91 patients) based on different postoperative drainage methods. Between the two groups, comparisons were made regarding the demographics, intraoperative and postoperative data, patient-reported outcomes, and complications.

Results

The NAPD group experienced less overall drainage and fewer postoperative drainage days (157.89 vs. 318.49 ml/249.54 vs. 589.43 ml, 2.00 vs. 2.67 days/2.04 vs. 2.74 days, P < 0.001) than the NEPD group. The NAPD group has a higher rate of overall hidden blood loss (HBL) than the NEPD group (63.98% vs. 51.90%/65.80% vs. 48.11%, P < 0.001); HBL, however, did not significantly differ between the two groups (P > 0.05). In two-segment surgery, the postoperative hemoglobin (HGB) levels were higher in the NAPD group (99.67 vs. 92.69 g/L, P < 0.05), but there was no difference in single-segment surgery (P > 0.05). Regardless of whether single- or two-segment surgery was performed, the NAPD group had a lower HGB level loss (18.81% vs. 21.63%/26.35% vs. 32.08%, P < 0.05). There was no discernible difference between the two groups in the visual analog scale (VAS) scores for symptomatic epidural hematoma, postoperative body temperature, low back and leg pain, or incision infection (P > 0.05).

Conclusion

NAPD did not increase postoperative complications but did significantly reduce postoperative drainage volume and the risk of anemia. We show that, when compared to NEPD, NAPD may be a better option for patients following TLIF.

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Funding

This study was supported by the Project of State Key Laboratory of Radiation Medicine and Protection, Soochow University (GZK1202128); Suzhou scientific research foundation of integrated traditional Chinese and Western Medicine (SKJYD2021220); Suzhou health talent plan (GSWS2021019).

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Author notes

  1. Fengxian Jiang and Han Wu have contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, 215006, China

    Fengxian Jiang, Han Wu, Mengyang Pu, Yixin Shen, Peng Zhang & Wentao Zhong

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  1. Fengxian Jiang
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Correspondence to Peng Zhang or Wentao Zhong.

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Ethical approval

This study was approved by the Second Affiliated Hospital of Soochow University's Ethics Committee (number: JD-HG-2020–22).

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An informed consent was obtained by all patients included in the study

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Jiang, F., Wu, H., Pu, M. et al. Natural pressure drainage versus negative pressure drainage following transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar degeneration disease: a prospective cohort study. Arch Orthop Trauma Surg 143, 6131–6138 (2023). https://doi.org/10.1007/s00402-023-04937-4

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