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. 2021 Sep;11(7):1148-1155.
doi: 10.1177/2192568220962439. Epub 2020 Oct 9.

Venous Thromboembolism Prophylaxis in Elective Spine Surgery

Samantha Solaru  1 , Ram K Alluri  2 , Jeffrey C Wang  3 , Raymond J Hah  4
Affiliations

Venous Thromboembolism Prophylaxis in Elective Spine Surgery

Samantha Solaru et al. Global Spine J. 2021 Sep.

Abstract

Study design: Review.

Objective: Venothromboembolic (VTE) complications, composed of deep vein thrombosis and pulmonary embolism are commonly observed in the perioperative setting. There are approximately 500 000 postoperative VTE cases annually in the United States and orthopedic procedures contribute significantly to this incidence. Data on the use of VTE prophylaxis in elective spinal surgery is sparse. This review aims to provide an updated consensus within the literature defining the risk factors, diagnosis, and the safety profile of routine use of pharmacological prophylaxis for VTE in elective spine surgery patients.

Methods: A comprehensive review of the literature and compilation of findings relating to current identified risk factors for VTE, diagnostic methods, and prophylactic intervention and safety in elective spine surgery.

Results: VTE prophylaxis use is still widely contested in elective spine surgery patients. The outlined benefits of mechanical prophylaxis compared with chemical prophylaxis varies among practitioners.

Conclusion: The benefits of any form of VTE prophylaxis continues to remain a controversial topic in the elective spine surgery setting. A specific set of guidelines for implementing prophylaxis is yet to be determined. As more risk factors for thromboembolic events are identified, the complexity surrounding intervention selection increases. The benefits of prophylaxis must also continue to be balanced against the increased risk of bleeding events and neurologic injury.

Keywords: deep vein thrombosis; elective spine surgery; epidural hematoma; prophylaxis; pulmonary embolism; venous thromboembolism.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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