title: Prevalence and risk factors for development of venous thromboembolism after degenerative spinal surgery.
abstract: METHODS
  Prospective clinical study.
  
  
  OBJECTIVE
  To identify the incidence and risk factors for venous thromboembolism (VTE) associated with degenerative spinal surgery procedures at the different spinal levels for various pathologies.
  
  
  BACKGROUND
  Spinal surgery includes procedures for treatment of various pathologies at different spinal levels. There have been no studies on VTE after degenerative spinal surgery with respect to screening patients for both deep venous thrombosis and pulmonary thromboembolism (PE).
  
  
  METHODS
  We prospectively investigated the occurrence of VTE after degenerative spinal surgery in 459 patients who were divided into 5 groups: group 1, patients with cervical degenerative disease treated with posterior decompression; group 2, patients with cervical degenerative disease treated with instrumentation for spinal fusion; group 3, patients with thoracolumbar degenerative disease treated with instrumentation for spinal fusion; group 4, patients with lumbar spinal stenosis treated with posterior decompression; and group 5, patients with lumbar spondylolisthesis treated with 1-level posterior lumbar interbody fusion. A deep venous thrombosis and PE screening was performed for all patients. Binomial logistic regression analysis was used to assess the association of risk factors.
  
  
  RESULTS
  The incidence of VTE was 2.8%, 3.4%, 10.8%, 12.5%, and 10.1% in groups 1, 2, 3, 4, and 5, respectively. Female sex, advanced age, spinal level, and neurological deficits, were all risk factors. Cervical spinal surgery in particular had an associated low risk. In patients with PE, 3 of the 4 had no deep venous thrombosis, indicating that screening for PE is also needed in high-risk patients.
  
  
  CONCLUSIONS
  The prevalence of VTE after elective spinal surgery was different in each group.
  
  
  METHODS
  3.
authors.affiliation: From the Department of Orthopaedic Surgery, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Katsuhito
authors.initials: K
authors.lastname: Yoshioka
authors.forename: Hideki
authors.initials: H
authors.lastname: Murakami
authors.forename: Satoru
authors.initials: S
authors.lastname: Demura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013122:Spinal Diseases / Q000453:epidemiology* / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects*; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology