Thromboembolic Complications Following Spine Surgery Assessed with Spiral CT Scans

DVT/PE Following Spine Surgery

Abstract

Spine surgery is associated with a significant risk of postoperative pulmonary embolism (PE) and/or deep vein thrombosis (DVT). The goal of this study was to determine which symptoms and risk factors were associated with spiral CT scans positive for PE and/or DVT in the postoperative spine surgery patient. We conducted a retrospective review of all spine patients who underwent a postoperative CT to rule out PE during the period of March 2004–February 2006. The type of surgical procedure, risk factors, symptoms prompting scan ordering, anticoagulation, and treatment were recorded. Logistic regression models were used to determine significant predictors of a positive CT in this patient population. Of the 3,331 patients that had spine surgery during the study period, 130 (3.9%) had a spiral CT scan to rule out PE and/or proximal DVT. Thirty-three of the 130 (25.4%) CT scans were positive for PE only, five (3.8%) for PE and DVT, and three (2.3%) for DVT only. Only 24.5% (32) patients had risk factors for thromboembolic disease, and of these, a history of PE and/or DVT was the only significant risk factor for a positive scan (p = 0.03). No presenting symptoms or demographic variables were noted to have a significant association with PE and/or DVT. The type of surgical procedure (i.e., anterior, posterior, and percutaneous) was not associated with an increased risk for PE and/or DVT. Patients who are undergoing spine surgery with a history of thromboembolic disease should be carefully monitored postoperatively and may benefit from more aggressive prophylaxis.

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Acknowledgement

The authors would like to acknowledge Lindsey Bornstein for her assistance in the preparation of this manuscript.

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Correspondence to Geoffrey H. Westrich MD.

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Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. No funding was received for this project.

Each author certifies that his or her institution has approved the reporting of these cases, that all investigations were conducted in conformity with ethical principles of research.

Level of Evidence: Level IV Prognostic Study

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Kim, H.J., Walcott-Sapp, S., Adler, R.S. et al. Thromboembolic Complications Following Spine Surgery Assessed with Spiral CT Scans. HSS Jrnl 7, 37–40 (2011). https://doi.org/10.1007/s11420-010-9179-7

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Keywords

  • spine surgery
  • spiral CT
  • thromboembolism