Up-to-date thromboprophylaxis in elective spinal surgery. A systematic review

Oliveira, Leonardo; Marchi, Luís; Pimenta, Luiz

doi:10.1590/s1808-18512014130200413

Cited by 2 publications

(1 citation statement)

References 40 publications

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“…Overall, the data produced by our study were close to those found in diverse publications in the literature. [26][27][28][29] One of the biases of the present study was the scarcity of prospective randomized clinical trials for analysis. In addition, it was not possible to perform an independent analysis of each outcome, such as DVT, PTE, and epidural hematoma, due to the small number of cases, so the forest plot graphs were not divided by outcome.…”

Section: Discussionmentioning

confidence: 94%

The Use of Chemoprophylaxis or Not for DVT in Spine Surgery: A Systematic Review

Cavassin

Brandalizze

et al. 2022

Coluna/Columna

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Objective: To compare pharmacological and non-pharmacological prophylaxis in elective spine surgery to determine the risks of DVT, PTE, and epidural hematoma (EH) in both groups, as well as their respective treatment effectiveness. Methods: Systematic review and meta-analysis based on systematically searched articles, using combinations of MeSH terms related to chemoprophylaxis and non-chemoprophylaxis for prevention of deep vein thrombosis and pulmonary embolism in elective spine surgery. Adult patients were eligible for inclusion in the study, except for those with trauma, spinal cord injury, neoplasms, or those using vena cava filters. Results: Five studies were selected for this systematic review and meta-analysis: 3 retrospective studies, 1 prospective study, and 1 case series. Data analysis showed that 4.64% of patients treated with chemoprophylaxis had an unfavorable outcome regarding DVT, while this outcome occurred in 1.14% of patients not treated with chemoprophylaxis (p=0.001). Among patients using chemoprophylaxis, only 0.1% developed epidural hematoma and 0.38% developed PTE. Among those on non-pharmaceutical prophylaxis, 0.04% had EH (p=0.11) and 0.42% had PTE (p=0.45). Conclusions: No benefits were found for chemoprophylaxis as compared to non-chemoprophylaxis in preventing DVT in elective spine surgery, nor was there an increased risk of epidural hematoma or fatal thromboembolic events. Level of evidence III; Therapeutic studies; Investigation of treatment results.

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Section: Discussionmentioning

confidence: 94%

The Use of Chemoprophylaxis or Not for DVT in Spine Surgery: A Systematic Review

Cavassin

Brandalizze

et al. 2022

Coluna/Columna

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Thromboprophylaxis in elective spinal surgery

et al. 2020

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Background: Venous thromboembolism (VTE) is a serious, sometimes life-threatening complication that can occur following spine surgery. The incidence of VTE, and the optimal type and timing of thromboprophylaxis for this complication in elective spine surgery is a matter of debate. Objective: To perform a systematic review with the aim of clarifying the efficacy and adverse effects of mechanical and chemical prophylaxis for preventing thromboembolic complications in elective spine surgery for conditions other than trauma and malignant disease. Methods/design: A search strategy of related articles up to March 2018 was designed and executed in Medline and Embase. Patients: adolescents (>10 years) and adults undergoing elective surgery for spinal deformity or degenerative disease (from C1 to S1). Intervention: Perioperative mechanical and chemical thromboprophylaxis. Studies could be randomized controlled trials or observational studies that reported data on any relevant clinical outcomes. Results: In total, 2451 uniquecitations were identified and 35 studies were ultimately included in the systematic review. The overall mean incidence of complications was 3.7% for deep venous thrombosis, 0.0% for pulmonary embolism, and 3.7% for bleeding in chemoprophylaxis group; 2.9% for deep venous thrombosis, 0.4% for pulmonary embolism and 0.0% for bleeding in mechanoprophylaxis; and 0.7% for deep venous thrombosis, 0.1% for pulmonary embolism and 0.2% for bleeding in mixed prophylaxis group with no specific data on these rates for the type of patient and type and location of surgery. None of the articles retrieved provided information on the adolescent population. Discussion and Conclusions: The poor design and high variability among the studies regarding characteristics of study population, details of interventions, and definitions of outcomes, determines a low quality of the available evidence and limits the interpretation of the results. We were unable to identify a clear advantage of one type of thromboprophylaxis over the other, although there was an increased risk of bleeding with chemoprophylaxis, which could favor the use of mechanoprophylaxis in this scenario.

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Up-to-date thromboprophylaxis in elective spinal surgery. A systematic review

Cited by 2 publications

References 40 publications

The Use of Chemoprophylaxis or Not for DVT in Spine Surgery: A Systematic Review

The Use of Chemoprophylaxis or Not for DVT in Spine Surgery: A Systematic Review

Thromboprophylaxis in elective spinal surgery

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