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.