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Thromboembolic complications after spinal surgery in trauma patients.
Acta Orthop. 2006 Oct; 77(5):755-60.AO

Abstract

BACKGROUND

Deep venous thrombosis (DVT) and pulmonary embolism (PE) may be significant complications following spinal surgery. The incidence rate ranges from 0.5% to 2.5% in patients with symptomatic thromboembolic disease and up to 15% in patients with non-symptomatic thrombotic complications. We determined the incidence of symptomatic thromboembolism after spinal surgery in patients with postoperative systemic prophylaxis and investigated general and specific risk factors for development of this disease.

PATIENTS AND METHODS

We analyzed the clinical records of 978 patients who had undergone surgery of the spine because of trauma and who had been admitted to our level-I trauma center between 1980 and 2004. Spinal procedures included anterior and/or posterior spinal fusion, video-assisted thoracoscopic fusion, and spinal decompression. Symptomatic thromboembolic disease was diagnosed when patients showed significant clinical signs or symptoms of DVT or PE. In cases of DVT, diagnosis was confirmed by duplex scan of the lower limbs; in cases of PE, diagnosis was confirmed by CT-scanning of the thorax or at post mortem.

RESULTS

The incidence rate of symptomatic thromboembolic complications was 2.2% (n 22). 17 patients showed clinical signs of deep venous thrombosis, with 4 of them developing pulmonary embolism subsequently. The other 5 patients developed pulmonary embolism without prior clinical signs of deep venous thrombosis. 6 patients died because of thromboembolic disease. Thromboembolic complications were more frequent in older patients and among males, as well as in patients with regular tobacco consumption and obesity. Thromboembolic complications were also seen more frequently in patients with surgical procedures at the lumbar spine, in patients with anterior spinal fusion, and in those with motor deficits in the lower extremities.

INTERPRETATION

We found a rather low rate of clinically significant thromboembolic complications after spinal surgery because of trauma, compared to the results reported in the literature. Level of spinal surgery, surgical approach, and motor deficits in the lower extremities were identified as specific risk factors for DVT or PE. Age, sex, obesity and regular smoking were identified as general risk factors.

Authors+Show Affiliations

Department of Traumatology, University of Vienna Medical School, Vienna, AT-1090, Austria. patrick.platzer@gmx.atNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17068706

Citation

Platzer, Patrick, et al. "Thromboembolic Complications After Spinal Surgery in Trauma Patients." Acta Orthopaedica, vol. 77, no. 5, 2006, pp. 755-60.
Platzer P, Thalhammer G, Jaindl M, et al. Thromboembolic complications after spinal surgery in trauma patients. Acta Orthop. 2006;77(5):755-60.
Platzer, P., Thalhammer, G., Jaindl, M., Obradovic, A., Benesch, T., Vecsei, V., & Gaebler, C. (2006). Thromboembolic complications after spinal surgery in trauma patients. Acta Orthopaedica, 77(5), 755-60.
Platzer P, et al. Thromboembolic Complications After Spinal Surgery in Trauma Patients. Acta Orthop. 2006;77(5):755-60. PubMed PMID: 17068706.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thromboembolic complications after spinal surgery in trauma patients. AU - Platzer,Patrick, AU - Thalhammer,Gerhild, AU - Jaindl,Manuela, AU - Obradovic,Alexandra, AU - Benesch,Thomas, AU - Vecsei,Vilmos, AU - Gaebler,Christian, PY - 2006/10/28/pubmed PY - 2006/12/9/medline PY - 2006/10/28/entrez SP - 755 EP - 60 JF - Acta orthopaedica JO - Acta Orthop VL - 77 IS - 5 N2 - BACKGROUND: Deep venous thrombosis (DVT) and pulmonary embolism (PE) may be significant complications following spinal surgery. The incidence rate ranges from 0.5% to 2.5% in patients with symptomatic thromboembolic disease and up to 15% in patients with non-symptomatic thrombotic complications. We determined the incidence of symptomatic thromboembolism after spinal surgery in patients with postoperative systemic prophylaxis and investigated general and specific risk factors for development of this disease. PATIENTS AND METHODS: We analyzed the clinical records of 978 patients who had undergone surgery of the spine because of trauma and who had been admitted to our level-I trauma center between 1980 and 2004. Spinal procedures included anterior and/or posterior spinal fusion, video-assisted thoracoscopic fusion, and spinal decompression. Symptomatic thromboembolic disease was diagnosed when patients showed significant clinical signs or symptoms of DVT or PE. In cases of DVT, diagnosis was confirmed by duplex scan of the lower limbs; in cases of PE, diagnosis was confirmed by CT-scanning of the thorax or at post mortem. RESULTS: The incidence rate of symptomatic thromboembolic complications was 2.2% (n 22). 17 patients showed clinical signs of deep venous thrombosis, with 4 of them developing pulmonary embolism subsequently. The other 5 patients developed pulmonary embolism without prior clinical signs of deep venous thrombosis. 6 patients died because of thromboembolic disease. Thromboembolic complications were more frequent in older patients and among males, as well as in patients with regular tobacco consumption and obesity. Thromboembolic complications were also seen more frequently in patients with surgical procedures at the lumbar spine, in patients with anterior spinal fusion, and in those with motor deficits in the lower extremities. INTERPRETATION: We found a rather low rate of clinically significant thromboembolic complications after spinal surgery because of trauma, compared to the results reported in the literature. Level of spinal surgery, surgical approach, and motor deficits in the lower extremities were identified as specific risk factors for DVT or PE. Age, sex, obesity and regular smoking were identified as general risk factors. SN - 1745-3674 UR - https://www.unboundmedicine.com/medline/citation/17068706/Thromboembolic_complications_after_spinal_surgery_in_trauma_patients_ L2 - https://www.tandfonline.com/doi/full/10.1080/17453670610012944 DB - PRIME DP - Unbound Medicine ER -