Thromboembolic events and spinal surgery.
Management of patients undergoing neurosurgical spinal procedures requires balancing the competing risks of hemorrhage and thrombosis. Deep venous thrombosis (DVT) and pulmonary embolism (PE) may be significant complications following spinal surgery. The authors reviewed 30 studies regarding thromboembolic events following spinal surgery for various etiologies and analysed all the methods used to prevent thromboembolic events. Despite the low incidence of DVT (2.7%) and PE (2%), most spinal surgeons routinely treat patients with a non-invasive prophylactic method such as pneumatic sequential compression devices or compression stockings. Chemoprophylaxis is another effective method to prevent thromboembolic episodes. Inferior vena cava filters may be a safe and effective method to prevent thromboembolic episodes in this patient cohort when chemoprophylaxis and mechanical compression is contraindicated.
The Johns Hopkins School of Medicine, The Johns Hopkins Hospital, Department of Neurosurgery, 550 North Broadway Street, Baltimore, MD 21231, USA.
Kyriakos
K
Papadimitriou
Anubhav G
AG
Amin
Ryan M
RM
Kretzer
Daniel M
DM
Sciubba
Ali
A
Bydon
Timothy F
TF
Witham
Jean-Paul
JP
Wolinsky
Ziya L
ZL
Gokaslan
Ali A
AA
Baaj
D000925:Anticoagulants / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D013116:Spinal Cord / Q000601:surgery*; D053828:Stockings, Compression; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D016306:Vena Cava Filters / Q000009:adverse effects
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight