Is submuscular drainage mandatory for posterior spinal fusion in adolescent idiopathic scoliosis? A retrospective clinical study.

OBJECTIVE

This single-center retrospective analysis was designed to evaluate the outcome of closed-suction wound drainage following posterior spinal fusion with internal instrumentation for mild to moderate adolescent idiopathic scoliosis (AIS).

METHODS

Eighty-six AIS patients undergoing posterior spinal fusion were divided into two cohorts: submuscular closed-suction wound drainage (n = 35) and simple compressed dressing clothes without wound drainage (n = 51). These two cohorts were thoroughly compared in terms of demographic distribution and perioperative blood loss, including hemoglobin and hematocrit levels and blood transfusion volumes. Additionally, the incidence of wound-related problems (pyrexia and wound complications), duration of hospital stay, and lumbar function evaluation (lumbar mobility and SRS-22 questionnaire scores) were annually assessed during at least 5-year follow-up.

RESULTS

The drainage group had significantly lower hemoglobin (93.73 g/L vs. 99.95 g/L, P = 0.01) and hematocrit levels (27.75% vs. 29.94%, P < 0.01) on the third postoperative day, as well as a significantly higher postoperative blood transfusion volume (40.0 mL vs. 23.5 mL, P = 0.011) compared to the non-drainage group. Furthermore, the duration of hospital stay was significantly longer in the drainage group than in the non-drainage group (10.9 d vs. 8.0 d, P < 0.01). In contrast, the two groups were statistically similar regarding duration of fever (0.9 d vs. 1.2 d, P = 0.268), incidence of wound problems, latest lumbar mobility (42.79° vs. 44.97°, P = 0.586), and scores of function/activity domain (16.74 vs. 16.08, P = 0.285) and pain domain (22.18 vs. 21.48, P = 0.374) in the SRS-22 questionnaire.

CONCLUSIONS

Routine closed-suction drainage significantly increased blood loss and hospital stay without obviously improving wound healing or functional outcomes. Utilizing simple compressed dressings without drainage was a clinically superior and resource-efficient alternative for posterior AIS fusion, particularly in uncomplicated primary surgeries for mild to moderate deformities.