Screening for deep venous thrombosis after idiopathic scoliosis surgery in children: a pilot study.
BACKGROUND
Venous thrombosis remains an uncommon disorder in childhood. However, the incidence appears to be increasing for a multitude of reasons. The aim of the study was to detect asymptomatic deep venous thrombosis and prothrombotic diseases in nonsyndromic children undergoing scoliosis surgery.


METHODS
A prospective study including forty successive teenagers scheduled for posterior spinal fusion. Patients with scoliosis with a history of hemoglobinopathies, cardiac defects, blood clots, early onset osteoporosis, as well as patients with skeletal dysplasias and nonskeletal dysplastic syndromic entities have been excluded. The protocol was designed for active screening of deep venous thrombosis using color Doppler ultrasonography on a day before surgery and repeated on the 3rd, 7th and 15th day postoperatively. Evaluation of prothrombotic disorders included antithrombin and protein C activities, and total protein S antigen level.


RESULTS
No patient has manifested clinical symptoms of venous thrombosis in our study. Preoperative Doppler and ultrasound examinations were normal in all patients. Although repeated Doppler ultrasonography demonstrated a transient small clot in two patients. Congenital antithrombin deficiency of 5% has been observed in one child only, without the development of deep venous thrombosis.


CONCLUSIONS
Thromboembolic event seems to be rare after scoliosis surgery. Prophylaxis for venous thrombosis should not be recommended in such patient. But, larger series are required to confirm such results.
Kaabachi
Olfa
O
Department of Anaesthesiology and Intensive Care Medicine, Kassab Orthopaedic Institute, Tunis, Tunisia. olfa.kaabachi@gnet.tn
Alkaissi
Ali
A
Koubaa
Walid
W
Aloui
Nadia
N
Toumi
Nour El Houda
Nel H
D000293:Adolescent; D000991:Antithrombins / Q000172:deficiency; D001772:Blood Cell Count; D001780:Blood Coagulation Tests; D002648:Child; D005260:Female; D005592:Fracture Fixation; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology; D010865:Pilot Projects; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology; D011446:Prospective Studies; D012600:Scoliosis / Q000601:surgery*; D018615:Ultrasonography, Doppler, Color; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology
D000991:Antithrombins