Multiple-day drainage when using bone morphogenic protein for long-segment thoracolumbar fusions is associated with low rates of wound complications.

Published

Journal Article

BACKGROUND: Concerns over increased wound complication rates have been raised when bone morphogenic protein (BMP) is used as an adjunct for fusion in spinal surgery. This study evaluated 87 consecutive patients undergoing long-segment thoracolumbar spinal fusions with BMP to assess drain output and the rates of reoperation for infection or seroma. METHODS: Inclusion criteria included patients undergoing 4 or more levels of posterior instrumented thoracolumbar fusion, use of BMP, age >18 years, and a perioperative follow-up of ≥60 days. Drain output, length of time of drainage, and need for reoperation for wound seroma or infection were reviewed. RESULTS: A total of 87 patients met inclusion criteria and had a mean age of 58.5 years (SD 16, range 20 to 81). The average number of levels instrumented and arthrodesed with BMP was 9.2 (SD 3.7; range 4 to 18), and the average dose of BMP used was 31.2 mg (SD 9.6, range 12 to 48) or 2.6 large sponges. Patients required drainage for a mean of 4.9 days (SD 1.3, range 3 to 9). The average total output was 1923 mL (SD 865, range 530 to 4310 mL). The wound infection rate was 2.3% (2 cases of deep wound infection that required reoperation). There was one (1.1%) hematoma, and one (1.1%) sterile seroma, both requiring evacuation. No other wound complications were noted. CONCLUSIONS: Use of BMP for long-segment posterior thoracolumbar fusions may be associated with significant drain output, requiring multiple days of drainage. However, when drained adequately, infections and seromas occur infrequently.

Full Text

Duke Authors

Cited Authors

  • Saulle, D; Fu, K-MG; Shaffrey, CI; Smith, JS

Published Date

  • July 2013

Published In

Volume / Issue

  • 80 / 1-2

Start / End Page

  • 204 - 207

PubMed ID

  • 22929109

Pubmed Central ID

  • 22929109

Electronic International Standard Serial Number (EISSN)

  • 1878-8769

Digital Object Identifier (DOI)

  • 10.1016/j.wneu.2012.08.003

Language

  • eng

Conference Location

  • United States