title: Deep venous thrombosis in spine surgery patients: incidence and hematoma formation.
abstract: Deep venous thrombosis (DVT) is a significant health care problem; a variety of factors place spinal surgery patients at high risk for DVT. Our aim is to define the incidence of DVT occurrence in spite of prophylactic measures (mechanical and chemoprophylaxis), and the development of spinal epidural hematoma as a complication of chemoprophylaxis. In a single-center prospective study, 158 patients who underwent spinal surgical procedures were evaluated by clinical evaluation and lower limb Doppler ultrasonography imaging. Only one patient (0.6%) developed DVT; this patient was treated successfully without thrombus progression, with full recanalization. Three patients (1.8%) developed spinal epidural hematoma, but only one required surgical evacuation, and none sustained neurologic deficit. Careful evaluation for DVT risk on an individual basis and good prophylaxis helps to minimize the risk of DVT. The neurosurgeon is thus left to weigh the risks of postoperative hematoma formation against the benefits of protecting against DVT.
authors.affiliation: Department of Surgery, the Neuro Spinal Hospital, Dubai, United Arab Emirates. thairabbas@gmail.com
authors.forename: Thair M
authors.initials: TM
authors.lastname: Al-Dujaili
authors.forename: Catalin N
authors.initials: CN
authors.lastname: Majer
authors.forename: Tarek E
authors.initials: TE
authors.lastname: Madhoun
authors.forename: Sebouh Z
authors.initials: SZ
authors.lastname: Kassis
authors.forename: Alaa A
authors.initials: AA
authors.lastname: Saleh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery; D002648:Child; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D017984:Enoxaparin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D046748:Hematoma, Epidural, Spinal / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011182:Postoperative Care; D011183:Postoperative Complications / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D018570:Risk Assessment; D053828:Stockings, Compression; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D017984:Enoxaparin; D005343:Fibrinolytic Agents