• Mourad Aggad, Louis-Marie Terrier, Chakib Nidal Salah, Ilyess Zemmoura, Alexia Planty-Bonjour, Patrick Francois, and Aymeric Amelot.
• Department of Neurosurgery, CHRU de Tours, Tours, France.
• Spine. 2024 Aug 1; 49 (15): 109210971092-1097.

Study DesignA retrospective single-center study between January 2019 and January 2023.ObjectiveThe role and contribution of drainage in the anterior approach to the cervical spine (cervicotomy) is much debated, motivated primarily by the prevention of retropharyngeal hematoma, so are there still any benefits to drainage?BackgroundThe anterior approach to the cervical spine is a widespread and common procedure performed in almost all spine surgery departments for the replacement of cervical intervertebral discs and medullar or radicular decompression. The primary endpoint was the occurrence of symptomatic postoperative cervical hematoma.Patients And MethodsFour hundred thirty-one patients who had undergone cervical spine surgery by anterior cervicotomy for cervicarthrosis or cervical disc herniation (anterior cervical discectomy and fusion and anterior cervical disc replacement) were consecutively included. Patients were separated into 2 groups: (1) Group A, 140 patients (with postoperative drainage) and (2) Group B, 291 patients (without drainage).ResultsThe mean follow-up was 2.8 months. The 2 groups were comparable on all criteria, but there was a predominance of arthroplasty ( P < 0.0001), use of anticoagulants/antiaggregants ( P < 0.0001) and a greater number of stages ( P < 0.0001) in group A. There were a total of 4/431 symptomatic postoperative hematomas (0.92%) in this study. Two hematomas occurred in group A (2/140, 1.4%) and 2 in group B (2/291, 0.68%; P < 0.0001). One patient in group A (0.71%) required surgical drainage for cavity hematoma revealed by marked dyspnea, swallowing, and neurological disorders. One case of hematoma diagnosed by dysphonia and neurological deficit was reported in group B (0.34%; P < 0.0001).ConclusionsThe placement of a drain during anterior cervicotomy (anterior cervical discectomy and fusion/anterior cervical disc replacement) did not limit the occurrence of symptomatic postoperative hematoma.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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