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Venous Thromboembolism Prophylaxis in Elective Spine Surgery
Samantha Solaru1, Ram K Alluri2, Jeffrey C Wang3
15116University of Southern California, Los Angeles, CA, USA.
Global Spine Journal
|October 9, 2020
Summary
Venothromboembolic (VTE) prophylaxis in spine surgery remains controversial. Current guidelines are lacking, and the benefits must be weighed against risks like bleeding and neurologic injury.
Area of Science:
- Spine Surgery
- Thromboembolic Complications
- Pharmacological Prophylaxis
Background:
- Venothromboembolic (VTE) complications, including deep vein thrombosis and pulmonary embolism, are frequent in the perioperative period.
- Orthopedic procedures are a significant contributor to the approximately 500,000 annual postoperative VTE cases in the U.S.
- Data regarding VTE prophylaxis in elective spine surgery is limited.
Purpose of the Study:
- To review current literature on VTE risk factors in elective spine surgery.
- To define diagnostic methods for VTE in this patient population.
- To assess the safety and efficacy of pharmacological VTE prophylaxis.
Main Methods:
- Comprehensive literature review.
- Compilation of findings on VTE risk factors, diagnosis, and prophylaxis.
- Analysis of the safety profile of pharmacological prophylaxis.
Main Results:
- The use of VTE prophylaxis in elective spine surgery is widely debated.
- Practitioner opinions vary regarding the benefits of mechanical versus chemical prophylaxis.
Conclusions:
- VTE prophylaxis in elective spine surgery is a controversial topic with no definitive guidelines.
- Increased identification of risk factors complicates intervention selection.
- Prophylaxis benefits must be balanced against risks of bleeding and neurologic injury.
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