Deep venous thrombosis following posterior lumbar spinal surgery.
Postoperative duplex scans were performed on 185 patients undergoing posterior lumbar spinal surgery in order to identify deep venous thrombosis (DVT). Elastic compression stockings were used for prophylaxis in 74 patients (Group E.S.); intermittent pneumatic compression was used in the remaining 111 patients (Group P.C.). High-risk patients were not eliminated from either group. Laminectomy was performed on 84 patients (40 from Group E.S. and 44 from Group P.C.), and spinal fusion, on 101 patients (34 from Group E.S. and 67 from Group P.C.). A total of four patients, all from Group E.S., developed acute postoperative DVT. Intermittent pneumatic compression significantly reduced the incidence of acute postoperative DVT (P < 0.05). No statistically significant differences were found in the incidence of DVT in relation to the type of spinal procedure, length of procedure, duration of bed rest, or age of the patient. In conclusion, considering the low rate of DVT (2%) following posterior lumbar surgery and the potential complications of prophylactic anticoagulation, we continue to use intermittent pneumatic compression rather than elastic stockings for prophylaxis.
Ferree
B A
BA
New England Baptist Hospital, Boston, Massachusetts.
Wright
A M
AM
D000328:Adult; D001458:Bandages; D005676:Gravity Suits; D006801:Humans; D015994:Incidence; D007796:Laminectomy; D007866:Leg / Q000098:blood supply; D008159:Lumbar Vertebrae / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors; D013123:Spinal Fusion; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control; D014463:Ultrasonography