Clinical comparison of submuscular drainage versus non-drainage combined with compressed dressing clothes following posterior spinal fusion on adolescent idiopathic scoliosis

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). 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 assessed during long-term follow-up. 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 (2.39 vs. 2.08, P = 0.336) and pain domain (1.76 vs. 1.66, P = 0.734) in the SRS-22 questionnaire. 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.