Higher Incidence of Thrombotic Complications in Thoracic Spine Surgery

Past studies have examined individual complication rates for cervical, lumbar, and thoracic spine surgery but have typically focused on just 1 region of the spine, making comparisons across spine regions difficult. The purpose of the present study was to analyze the incidence of 5 thrombotic complications, including pulmonary embolism, deep vein thrombosis, myocardial infarction, cardiac arrest, and stroke/cerebrovascular accident, across surgical procedures that target different regions of the spine, including cervical, thoracic, and lumbar.

We conducted a cross-sectional clinical analysis of these 5 thrombotic complications in a relatively large sample. Archival records from the National Surgical Quality Improvement Program database were retrieved and analyzed. We identified 7160 patients in the clinic population who underwent elective cervical, thoracic, or lumbar spine surgery. The records contained diagnoses of each of the 5 thrombotic complications made by a board-certified physician applying American Medical Association assessment procedures.

Findings indicated that the incidence of overall thrombotic complications was relatively low, with only 0.92% of patients (66 of 7160) having any complication. The complication rates differed by type and surgical region of the spine, such that thoracic procedures resulted in a greater percentage of complications (χ ²(1) = 14.83, P < 0.001) than cervical or lumbar procedures. Pulmonary embolism in particular occurred with greater likelihood in thoracic procedures and relatively lower likelihood in cervical and lumbar procedures (χ ²(1) = 16.43, P < 0.001).

Thoracic surgeries pose the greatest risk for thrombotic complications. Of the thrombotic complications that may occur during thoracic surgeries, pulmonary embolism is the most common.

These findings highlight the need for surgeons to pay particular attention to the risk of certain complications when performing surgeries in specific regions of the spine.