Does the number of drain tubes influence the formation of postoperative spinal epidural hematoma following biportal endoscopic unilateral laminotomy for bilateral decompression (BE-ULBD) in patients with two-level adjacent lumbar spinal stenosis? a prospective randomized study.

IF 2.8 3区医学 Q1 ORTHOPEDICS

Journal of Orthopaedic Surgery and Research Pub Date : 2025-06-24 DOI:10.1186/s13018-025-06042-1

Zhuolin Zhong, Jingjing Ying, Shaohua Zhang, Kaili Cai, Xiaowei Jing, Zhengyu Xu, Lejian Jiang, Tianxin Wu, Guojun Wei, Qingfeng Hu

{"title":"Does the number of drain tubes influence the formation of postoperative spinal epidural hematoma following biportal endoscopic unilateral laminotomy for bilateral decompression (BE-ULBD) in patients with two-level adjacent lumbar spinal stenosis? a prospective randomized study.","authors":"Zhuolin Zhong, Jingjing Ying, Shaohua Zhang, Kaili Cai, Xiaowei Jing, Zhengyu Xu, Lejian Jiang, Tianxin Wu, Guojun Wei, Qingfeng Hu","doi":"10.1186/s13018-025-06042-1","DOIUrl":null,"url":null,"abstract":"Background: The formation of postoperative spinal epidural hematoma (POSEH) following lumbar spinal surgery is a potentially serious complication. The efficacy and necessity of prophylactic postoperative drain tubes in preventing symptomatic postoperative spinal epidural hematoma (SPOSEH) after lumbar spinal decompression remain subjects of ongoing debate. The objective of this study is to investigate the potential impact of the number of drain tubes on POSEH following biportal endoscopic unilateral laminotomy for bilateral decompression (BE-ULBD) in patients of two-level adjacent lumbar spinal stenosis.Methods: A prospective randomized study was conducted involving 89 patients with two-level adjacent lumbar spinal stenosis who underwent BE-ULBD. Patients were divided into two groups: Group A (one drain tube) and Group B (two drain tubes). Demographic data were collected, including preoperative visual analog scale (VAS) scores for leg pain and preoperative blood pressure (BP). Postoperative BP was recorded. The primary outcome was the cross-sectional area (CSA) of POSEH assessed at 72 h postoperatively. Secondary outcomes included postoperative VAS scores for leg pain, volume of drainage output, and length of hospital stay.Results: A total of forty-three patients were assigned to Group A, while forty-six patients were assigned to Group B. The demographic characteristics of the patients in both groups were comparable. No significant differences were observed between the two groups regarding the CSA of POSEH. However, a significantly greater volume was noted in Group B (P = 0.015). There were no significant differences between the groups for other secondary outcomes, including postoperative VAS scores for leg pain (P = 0.584), and length of hospital stay (P = 0.428).Conclusions: More drain tubes may result in statistically significant output but not clinically significant differences in influencing the formation of POSEH following BE-ULBD for two-level adjacent lumbar spinal stenosis.Trial registration: The study was retrospectively registered in ClinicalTrials.gov on March 1, 2024, with the registration number NCT06290791.","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"615"},"PeriodicalIF":2.8000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186364/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Surgery and Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13018-025-06042-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The formation of postoperative spinal epidural hematoma (POSEH) following lumbar spinal surgery is a potentially serious complication. The efficacy and necessity of prophylactic postoperative drain tubes in preventing symptomatic postoperative spinal epidural hematoma (SPOSEH) after lumbar spinal decompression remain subjects of ongoing debate. The objective of this study is to investigate the potential impact of the number of drain tubes on POSEH following biportal endoscopic unilateral laminotomy for bilateral decompression (BE-ULBD) in patients of two-level adjacent lumbar spinal stenosis.

Methods: A prospective randomized study was conducted involving 89 patients with two-level adjacent lumbar spinal stenosis who underwent BE-ULBD. Patients were divided into two groups: Group A (one drain tube) and Group B (two drain tubes). Demographic data were collected, including preoperative visual analog scale (VAS) scores for leg pain and preoperative blood pressure (BP). Postoperative BP was recorded. The primary outcome was the cross-sectional area (CSA) of POSEH assessed at 72 h postoperatively. Secondary outcomes included postoperative VAS scores for leg pain, volume of drainage output, and length of hospital stay.

Results: A total of forty-three patients were assigned to Group A, while forty-six patients were assigned to Group B. The demographic characteristics of the patients in both groups were comparable. No significant differences were observed between the two groups regarding the CSA of POSEH. However, a significantly greater volume was noted in Group B (P = 0.015). There were no significant differences between the groups for other secondary outcomes, including postoperative VAS scores for leg pain (P = 0.584), and length of hospital stay (P = 0.428).

Conclusions: More drain tubes may result in statistically significant output but not clinically significant differences in influencing the formation of POSEH following BE-ULBD for two-level adjacent lumbar spinal stenosis.

Trial registration: The study was retrospectively registered in ClinicalTrials.gov on March 1, 2024, with the registration number NCT06290791.

查看原文本刊更多论文

双节段相邻腰椎管狭窄患者行双门静脉内窥镜单侧椎板切开术（BE-ULBD）后硬膜外血肿的形成与引流管的数量有关吗？一项前瞻性随机研究。

背景：腰椎手术后脊髓硬膜外血肿（POSEH）的形成是一种潜在的严重并发症。预防性术后引流管预防腰椎减压术后症状性脊髓硬膜外血肿（SPOSEH）的有效性和必要性仍然是争论的主题。本研究的目的是探讨双节段相邻腰椎管狭窄患者双门静脉内窥镜单侧椎板切开术双侧减压（BE-ULBD）后引流管数量对POSEH的潜在影响。方法：对89例行BE-ULBD的两节段相邻腰椎管狭窄患者进行前瞻性随机研究。患者分为两组：A组（1根引流管）和B组（2根引流管）。收集人口统计学数据，包括术前视觉模拟量表（VAS）腿部疼痛评分和术前血压（BP）。记录术后血压。主要结果是术后72小时评估POSEH的横截面积（CSA）。次要结局包括术后腿部疼痛的VAS评分、引流量和住院时间。结果：A组43例，b组46例，两组患者人口学特征具有可比性。两组间在posh的CSA方面无显著差异。然而，B组的体积明显更大（P = 0.015）。其他次要结局，包括术后腿部疼痛的VAS评分（P = 0.584）和住院时间（P = 0.428），两组间无显著差异。结论：更多的引流管可能导致输出量有统计学意义，但对两节段相邻腰椎管狭窄BE-ULBD术后POSEH形成的影响无临床意义。试验注册：该研究于2024年3月1日在ClinicalTrials.gov上回顾性注册，注册号为NCT06290791。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

CiteScore

4.10

自引率

7.70%

发文量

494

审稿时长

>12 weeks

期刊介绍： Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.