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Thromboprophylaxis in elective spinal surgery: A protocol for systematic review
María J Colomina1, Joan Bagó2, Javier Pérez-Bracchiglione3
1Department of Anaesthesiology and Intensive Care, Hospital Universitari Bellvitge, L'Hospitalet de LLobregat, Barcelona, Universitat de Barcelona.
Medicine
|June 3, 2020
Summary
Venous thromboembolism (VTE) prophylaxis after spine surgery lacks high-quality evidence. Mechanical prophylaxis may reduce bleeding risk compared to chemical methods, but clear advantages remain uncertain.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Evidence-Based Medicine
Background:
- Venous thromboembolism (VTE) is a significant complication following spine surgery.
- Optimal thromboprophylaxis strategies for elective spine surgery remain debated.
Purpose of the Study:
- To systematically review the efficacy and adverse effects of mechanical and chemical prophylaxis for VTE prevention.
- Focus on elective spine surgery for degenerative or deformity conditions, excluding trauma and malignancy.
Main Methods:
- Systematic review of randomized controlled trials and observational studies up to March 2018.
- Searches conducted in Medline and Embase databases.
- Included adult patients undergoing elective spine surgery (C1-S1).
Main Results:
- 35 studies included from 2451 citations.
- Incidence rates: DVT (0.7%-3.7%), PE (0%-0.4%), bleeding (0%-3.7%) across prophylaxis groups.
- No specific data for adolescent populations.
Conclusions:
- Low quality of evidence due to study design variability.
- No clear advantage of one prophylaxis type over another identified.
- Increased bleeding risk with chemoprophylaxis suggests potential benefit of mechanoprophylaxis.
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