J Korean Neurosurg Soc.  2015 Feb;57(2):114-118. 10.3340/jkns.2015.57.2.114.

Incidence of Venous Thromboembolic Complications in Instrumental Spinal Surgeries with Preoperative Chemoprophylaxis

• Hamidi S
• Riazi M

• KMID: 2191192
• DOI: http://doi.org/10.3340/jkns.2015.57.2.114

Abstract

OBJECTIVE
Venous thromboembolism (VTE) after spinal surgery affects a patients' postoperative recovery and also carries a mortality risk. Some studies recommended chemical prophylaxis for high-risk patients and for those after complex spinal surgeries. However, chemoprophylaxis for VTE in spinal surgery is underemployed and there is no agreement on the use of VTE prophylaxis in spinal surgery. The aim of this study was to document the incidence of VTE after an elective instrumental spinal surgery, among those receiving preoperative chemoprophylaxis as compared with patients who did not receive it.
METHODS
This study was carried out on eighty-nine patients allocated randomly to receive either low molecular weight heparin (LMWH) or no prophylaxis before elective instrumental spinal surgery. All patients received postoperative compression stockings. A compression Doppler ultrasonography was performed for all patients to detect postoperative deep vein thrombosis. In addition, further imaging studies were performed for patients suspected of VTE.
RESULTS
Three (3.3%) patients were diagnosed with VTE. One of them had received preoperative chemoprophylaxis. There were no significant difference in incidence of VTE between the two groups (p>0.95; 95% confidence interval, 0.06-8.7). Laterality of gender and postsurgical recumbence duration were all independent predictors of VTE (p=0.01 and p<0.001, respectively).
CONCLUSION
The difference in the incidence of thromboembolic complications between the two groups was not significant. Moreover, we found that preoperative prophylactic LMWH injection has no major bleeding complications altering postoperative course; still, the issue concerning the initiation time of chemoprophylaxis in spinal surgery remains unclear.

Keyword

Venous thromboembolism; Deep vein thrombosis; Pulmonary embolism; Spinal surgery; Preoperative; Low molecular weight heparin

MeSH Terms

Chemoprevention*
Hemorrhage
Heparin, Low-Molecular-Weight
Humans
Incidence*
Mortality
Pulmonary Embolism
Stockings, Compression
Ultrasonography, Doppler
Venous Thromboembolism
Venous Thrombosis
Heparin, Low-Molecular-Weight

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