D-dimer predicts pulmonary embolism after low-risk spine surgery

Area of Science:

• Orthopedic Surgery
• Vascular Surgery
• Hematology

Background:

• Pulmonary embolism (PE) is a significant cause of mortality after spine surgery.
• Deep venous thrombosis (DVT) can lead to PE, but the impact of venous thromboembolism (VTE) on blood markers post-spine surgery is not well understood.
• This study investigates blood marker changes associated with PE or DVT following low-risk cervical laminoplasty or lumbar laminectomy.

Purpose of the Study:

• To examine changes in blood markers in patients who develop PE or DVT after low-risk spine surgery.
• To identify potential predictive factors for early diagnosis of VTE after spinal procedures.
• To explore the relationship between DVT and PE in the context of spine surgery.

Main Methods:

• Seventy-two patients undergoing spine surgery were monitored.
• Computed tomography (CT) scans were performed pre- and post-surgery.
• Plasma levels of soluble fibrin monomer complex, D-dimer, PAI-1, white blood cells, and platelets were measured at multiple time points.

Main Results:

• No symptomatic VTE occurred, but asymptomatic PE and DVT were detected in some patients.
• Postoperative D-dimer levels at days 3 and 7 were significantly higher in the PE group.
• Preoperative PAI-1 levels were significantly higher in patients who developed DVT or VTE.

Conclusions:

• Elevated postoperative D-dimer (days 3 and 7) predicts early PE diagnosis after spine surgery.
• Elevated preoperative PAI-1 predicts early DVT and VTE diagnosis.
• PE may develop independently of DVT, suggesting alternative pathways.