title: Risk factors for venous thromboembolism after spine surgery.
abstract: The efficacy and safety of chemical prophylaxis to prevent the development of deep venous thrombosis (DVT) or pulmonary embolism (PE) following spine surgery are controversial because of the possibility of epidural hematoma formation. Postoperative venous thromboembolism (VTE) after spine surgery occurs at a frequency similar to that seen after joint operations, so it is important to identify the risk factors for VTE formation following spine surgery. We therefore retrospectively studied data from patients who had undergone spinal surgery and developed postoperative VTE to identify those risk factors. We conducted a retrospective clinical study with logistic regression analysis of a group of 80 patients who had undergone spine surgery at our institution from June 2012 to August 2013. All patients had been screened by ultrasonography for DVT in the lower extremities. Parameters of the patients with VTE were compared with those without VTE using the Mann-Whitney U-test and Fisher exact probability test. Logistic regression analysis was used to analyze the risk factors associated with VTE. A value of P < 0.05 was used to denote statistical significance. The prevalence of VTE was 25.0% (20/80 patients). One patient had sensed some incongruity in the chest area, but the vital signs of all patients were stable. VTEs had developed in the pulmonary artery in one patient, in the superficial femoral vein in one patient, in the popliteal vein in two patients, and in the soleal vein in 18 patients. The Mann-Whitney U-test and Fisher exact probability test showed that, except for preoperative walking disability, none of the parameters showed a significant difference between patients with and without VTE. Risk factors identified in the multivariate logistic regression analysis were preoperative walking disability and age. The prevalence of VTE after spine surgery was relatively high. The most important risk factor for developing postoperative VTE was preoperative walking disability. Gait training during the early postoperative period is required to prevent VTE.
authors: From the Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan (HT, FT IK, SN, MA, TY, SK); The Near-Future Locomotor Organ Medicine Creation Course (Kusunoki Kai), Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan (HT, TS); Department of Orthopaedic Surgery, Izumi Regional Medical Center, 4513 Akasegawa, Akune 899-1611, Japan (YT, NK); Division of Medical and Environmental Safety, Kagoshima University Medical and Dental Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan (KY); and Physical Therapy Department, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan (KY).
authors: Hiroyuki
authors: H
authors: Tominaga
authors: Takao
authors: T
authors: Setoguchi
authors: Fumito
authors: F
authors: Tanabe
authors: Ichiro
authors: I
authors: Kawamura
authors: Yasuhiro
authors: Y
authors: Tsuneyoshi
authors: Naoya
authors: N
authors: Kawabata
authors: Satoshi
authors: S
authors: Nagano
authors: Masahiko
authors: M
authors: Abematsu
authors: Takuya
authors: T
authors: Yamamoto
authors: Kazunori
authors: K
authors: Yone
authors: Setsuro
authors: S
authors: Komiya
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000453:epidemiology*
references: J Neurosurg. 1995 Jul;83(1):1-7
references: 7782824
references: Spine (Phila Pa 1976). 1996 Apr 1;21(7):853-8; discussion 859
references: 8779018
references: Med Clin North Am. 2003 Nov;87(6):1157-64
references: 14680297
references: Chin Med Sci J. 2011 Dec;26(4):221-6
references: 22218049
references: Spine (Phila Pa 1976). 2013 Nov 1;38(23):E1498-502
references: 23873245
references: J Orthop Sci. 2012 Mar;17(2):114-7
references: 22222443
references: Spine (Phila Pa 1976). 2013 Oct 1;38(21):1892-8
references: 23778367
references: Neurosurg Focus. 2004 Jun 15;16(6):e1
references: 15202871
references: Surg Neurol Int. 2013 Oct 29;4(Suppl 5):S383-91
references: 24340237
references: Spine J. 2014 Dec 1;14(12):2847-53
references: 24704677
references: Case Rep Orthop. 2013;2013:621405
references: 24369516
references: J Vasc Surg. 2010 Nov;52(5):1246-50
references: 20630682
references: J Bone Joint Surg Am. 2010 Feb;92(2):304-13
references: 20124056
references: J Spinal Disord Tech. 2015 Jun;28(5):E310-5
references: 23511649
references: Eur Spine J. 2008 Jul;17(7):970-4
references: 18421483
references: J Bone Joint Surg Am. 2011 Dec 21;93(24):e146
references: 22258781
references: Vascular. 2011 Feb;19(1):29-33
references: 21489924
references: Spine J. 2009 Dec;9(12):1046-51
references: 19931184
references: Surg Neurol. 1981 May;15(5):389-401
references: 9760981