Efficacy of prophylactic placement of inferior vena cava filter in patients undergoing spinal surgery.
METHODS
Retrospective case series.


OBJECTIVE
To evaluate the safety and efficacy of prophylactic inferior vena cava filter (IVCF) to prevent pulmonary embolism (PE) in high risk patients undergoing major complex spinal surgery.


BACKGROUND
PE has been reported to be the major cause of death after spinal reconstructive surgery. Mechanical prophylaxis alone is often not sufficient whereas anticoagulation therapy carries a significant risk of bleeding complications. Prophylactic IVCF placement is advocated in high-risk patients.


METHODS
A total of 129 high-risk patients undergoing complex spine surgery, having prophylactic IVCF were compared to a matched cohort of age, diagnosis, and risk factors of 193 patients for whom only mechanical prophylaxis was used. Patients were observed for potential complications related to the IVCF and also for clinical signs and symptoms of PE.


RESULTS
Eight cases (4.2%) of symptomatic PE were detected in the matched cohort control group (5 cases having combined anterior + posterior surgery and 3 patients having only posterior surgery). One of them died due to massive PE (0.5%). Symptomatic PE was detected in only 2 patients (1.5%), having combined anterior + posterior surgery due to lumbar spinal stenosis in IVCF group who responded well to medical treatment (P < 0.05). No complications were associated with filter insertion.


CONCLUSIONS
Prophylactic IVCF is effective and safe in prevention of pulmonary embolism in patients with risk factors for PE.
Ozturk
Cagatay
C
Istanbul Spine Center, Florence Nightingale Hospital, Istanbul, Turkey. cgtyztrk@yahoo.com
Ganiyusufoglu
Kursat
K
Alanay
Ahmet
A
Aydogan
Mehmet
M
Onat
Levent
L
Hamzaoglu
Azmi
A
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D013131:Spine / Q000601:surgery*; D016896:Treatment Outcome; D016306:Vena Cava Filters / Q000009:adverse effects; D020246:Venous Thrombosis / Q000517:prevention & control