Deep Venous Thrombosis of Lower Limb after Thoracolumbar Surgery: (A Prospective Cohort Study)

Asadian, Najmoddin; Mahdavi, Seyed Mani; Hajahmadi, Marjan

doi:10.22034/ijos.2022.355855.1036

Deep Venous Thrombosis of Lower Limb after Thoracolumbar Surgery: (A Prospective Cohort Study)

Document Type : Original Article

Authors

Najmoddin Asadian ¹

Seyed Mani Mahdavi ²

Marjan Hajahmadi ³

¹ Iran University of Medical Sciences, Tehran, Iran.

² Assistant professor, Department of Orthopaedics, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

³ Assistant professor, Heart and Vascular Training Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

https://doi.org/10.22034/ijos.2022.355855.1036

Abstract

Background: Spinal cord surgery, particularly thoracolumbar surgery, is associated with deep vein thrombosis (DVT). Therefore, this study aimed to evaluate the incidence rate of deep vein thrombosis after thoracolumbar surgery using Doppler sonography.
Methods: This prospective cohort study was conducted on 51 patients with spinal cord and thoracolumbar surgeries from January 2021 to October 2021. All the patients were evaluated for DVT by Doppler sonography one day before and one month after surgery. The elastic stockings were worn by all the cases, and low molecular weight Heparin (LMWH) was started after surgery and continued for two weeks.
Results: According to preoperative results, no evidence of DVT was present. Based on Doppler sonography results, the incidence rate of DVT was 3.92% one month after surgery. Clinical thrombosis was not detected in any of the patients.
Conclusion: According to the results, the DVT incidence rate was 3.9% in patients with Thoracolumbar Surgery. Prophylaxis needs to be seriously considered because DVT is a life-threatening issue.

Keywords

Deep venous thrombosis

Spine

Spinal cord

Operative surgical procedures

1. Wang H. Pei H. Ding W. Yang D. Ma L. et al. Risk factors of postoperative deep vein thrombosis (DVT) under low molecular weight heparin (LMWH) prophylaxis in patients with thoracolumbar fractures caused by high-energy injuries. J Thromb Thrombolysis. 2021; 51(2):397-404. PMID: 32562101 DOI: 10.1007/s11239-020-02192-7.

2. Kepler CK. McKenzie J. Kreitz T. Vaccaro A. et al. Venous thromboembolism prophylaxis in spine surgery. J Am Acad Orthop Surg. 2018; 26(14):489-500. PMID: 29870417 DOI: 10.5435/JAAOS-D-17-00561.

3. Sharif-Kashani B. Mohebi-Nejad A. Abooturabi S-M. et al.Estimated prevalence of venous thromboembolism in Iran: Prophylaxis still an unmet challenge. Tanaffos. 2015; 14(1):27-33. PMID: 26221149 PMCID: PMC4515327.

4. Khosravi A. Gharipour M. Abdar Isfahani M. Mohajeri H. Saadatnia M. et al. Perspective on the hospital incidence rate of deep venous coagulopathy: Clinical and biochemical diagnostic markers. Adv Biomed Res. 2014; 12; 3:254. PMID: 25590032 PMCID: PMC4283241 DOI: 10.4103/2277-9175.146924.

5. Dehghani, K., et al., Effect of Vitamin D deficiency in lower extremity and pulmonary venous thromboembolism. Biomedical Research and Therapy, 2019. 6(4): p. 3107-3112.

6. Prandoni P. W A Lensing A. Piccioli A. Bernardi E. Simioni P. et al. Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood. 2002; 100(10):3484-8. PMID: 12393647 DOI: 10.1182/blood-2002-01-0108.

7. Trujillo-Santos J. Antonio Nieto J. Tiberio G. Piccioli A. Di Micco P. et al. Predicting recurrences or major bleeding in cancer patients with venous thromboembolism. Findings from the RIETE Registry. Thromb Haemost. 2008; 100(3):435-9. PMID: 18766259.

8. Molahosseini Kahnoji, R. and M. Nikoobakht, The frequency assessment of deep vein thrombosis and its associated risk Factors in patients undergoing neurosurgical procedures. Razi Journal of Medical Sciences, 2010. 17(77): p. 74-80.

9. Bang S-M. Ju Jang M. Oh D. Kim Y-K. Kim I. et al. Korean guidelines for the prevention of venous thromboembolism. J Korean Med Sci. 2010; 25(11):1553-9. PMID: 21060742 PMCID: PMC2966990 DOI: 10.3346/jkms.2010.25.11.1553.

10. Bang S-M. Ju Jang M. Kim K. Yhim H-Y. Kim Y-K. et al. Prevention of venous thromboembolism , 2nd edition: korean society of thrombosis and hemostasis evidence-based clinical practice guidelines. J Korean Med ScI. 2014; 29(2):164-71.PMID: 24550640 PMCID: PMC3923992 DOI: 10.3346/jkms.2014.29.2.164.

11. Yang S-D. Liu H. Sun Y-P. Yang D-L. Shen Y. et al. Prevalence and risk factors of deep vein thrombosis in patients after spine surgery: a retrospective case-cohort study. Sci Rep. 2015; 5:11834. PMID: 26135271 PMCID: PMC4488742 DOI: 10.1038/srep11834.

12. Schulte L M. R O'Brien J. Bean M C. Pierce T P. Yu W D. et al. Deep vein thrombosis and pulmonary embolism after spine surgery: incidence and patient risk factors. Am J Orthop. 2013;42(6):267-70. PMID: 23805420.

13. Lee H M. Suk K S. Moon S H. Kim D J. Wang J M. et al. Deep vein thrombosis after major spinal surgery: incidence in an East Asian population. Spine. 2000; 25(14):1827-30. PMID: 10888952 DOI: 10.1097/00007632-200007150-00014.

14. Park J H. Lee K E. Yu Y M. Park Y H. Choi S A. et al. Incidence and risk factors for venous thromboembolism after spine surgery in Korean patients. World Neurosurg. 2019; 128:e289-e307. PMID: 31028984 DOI: 10.1016/j.wneu.2019.04.140.

15. Oda T. Fuji T. Kato Y. Fujita S. Kanemitsu N. et al. Deep venous thrombosis after posterior spinal surgery. Spine. 2000; 25(22):2962-7. PMID: 11074685 DOI: 10.1097/00007632-200011150-00019.