The Incidence and Mortality of Thromboembolic Events in Cervical Spine Surgery

Oglesby, Matthew; Fineberg, Steven J.; Patel, Alpesh A.; Pelton, Miguel A.; Singh, Kern

doi:10.1097/brs.0b013e3182897839

Cited by 47 publications

(36 citation statements)

References 22 publications

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Section: Discussionmentioning

confidence: 99%

“…Thromboembolic events are potential complications of cervical spine surgery [7]. The incidence of DVT in patients who undergo cervical spine surgery has been reported to be 0.5-4.5% [5,7,14]. However, the incidence of DVT development in patients who undergo cervical degenerative spinal surgery is controversial because previous studies have included patients with acute traumatic spinal cord injury, spinal tumors, rheumatoid arthritis, and infectious diseases [5,7,14].…”

Section: Discussionmentioning

confidence: 99%

“…Prevention, early detection, and timely treatment of DVT are very important during the perioperative period of spinal surgery [3]. According to various reports, the incidence of DVT in patients who undergo spinal surgery ranges from 0.3 to 31% [4][5][6][7]. The incidence of DVT has been reported to vary depending on the type of disease, spinal level, method of surveillance, DVT prophylaxis, and surveillance period [5,8].…”

Section: Introductionmentioning

confidence: 99%

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Rapidly progressive cervical myelopathy had a high risk of developing deep venous thrombosis: a prospective observational study in 289 cases with degenerative cervical spine disease

et al. 2018

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Study design A prospective observational study. Objectives To determine the incidence of deep venous thrombosis (DVT) and to evaluate the risk factors for DVT development associated with degenerative cervical spine disease. Setting Hokkaido Spinal Cord Injury Center, Japan. Methods Between April 2008 and March 2015, patients with degenerative cervical spine disease, such as compressive myelopathy or radiculopathy, who underwent surgical treatment were prospectively assessed. Leg vein ultrasonography and D-dimer tests were performed preoperatively and at 4 days after surgery. All patients received treatment with intermittent pneumatic compression and elastic stockings for primary DVT prophylaxis. No anticoagulation medications were used for DVT prophylaxis. Results A total of 289 patients (203 males, 86 females; median age: 67 years (interquartile range, 58-76)) were included. Nine patients (3.1%) exhibited DVT during the perioperative period. All 9 cases were women who had distal DVT. The incidences of preoperative and postoperative DVT were 1.1% and 2.1%, respectively. The univariate analysis showed that statistically significant risk factors for perioperative DVT included female gender (P < 0.01), advanced age (P = 0.04), a low Japanese Orthopaedic Association score (P = 0.03), rapidly progressive myelopathy (P < 0.01), and inability to walk (P = 0.01). The multivariate analysis showed that rapidly progressive myelopathy (P = 0.04) was the most important risk factor. Conclusion Female gender and rapidly progressive myelopathy are high-risk factors that predict the development of DVT during the perioperative period of cervical spine surgery. This result indicates that screening and treatment for DVT are needed in such high-risk patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rapidly progressive cervical myelopathy had a high risk of developing deep venous thrombosis: a prospective observational study in 289 cases with degenerative cervical spine disease

et al. 2018

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“…The reported mortality rate after ACDF and lumbar spine decompression without fusion in recently published large series is reported to be in the range of 0.1% to 0.3%. 14,[21][22][23] The 2 major risk factors for surgical mortality in these series are high age and high comorbidity score. Our 30-day mortality of 0% is in agreement with these recent reports.…”

Section: Surgical Mortalitymentioning

confidence: 94%

Outpatient Cervical and Lumbar Spine Surgery is Feasible and Safe

et al. 2015

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This series of 1449 consecutive outpatient microsurgical spine decompressions adds to the growing literature in favor of outpatient spinal surgery in properly selected patients. In our study, 99.8% of the patients were successfully discharged either to their homes or to a hotel on the day of surgery. The overall complication rate was 3.5%, surgical mortality was 0%, and only 1.5% had to be admitted to a hospital within 3 months after surgery.

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“…Acute blood loss induces peripheral circulatory failure, which increases the risk of serious complications such as stroke, myocardial infarction, and pulmonary embolism [1, 2]. Furthermore, postoperative bleeding may cause symptomatic hematoma, leading to consequent neurological or blood flow deterioration that requires emergency reoperation [3].…”

Section: Introductionmentioning

confidence: 99%

Hemostatic function to regulate perioperative bleeding in patients undergoing spinal surgery: A prospective observational study

et al. 2017

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Although bleeding is a common complication of surgery, routine laboratory tests have been demonstrated to have a low ability to predict perioperative bleeding. Better understanding of hemostatic function during surgery would lead to identification of high-risk patients for bleeding. Here, we aimed to elucidate hemostatic mechanisms to determine perioperative bleeding. We prospectively enrolled 104 patients undergoing cervical spinal surgery without bleeding diathesis. Blood sampling was performed just before the operation. Volumes of perioperative blood loss were compared with the results of detailed laboratory tests assessing primary hemostasis, secondary hemostasis, and fibrinolysis. Platelet aggregations induced by several agonists correlated with each other, and only two latent factors determined inter-individual difference. Platelet aggregability independently determined perioperative bleeding. We also identified low levels of plasminogen-activator inhibitor-1 (PAI-1) and α2-plasmin inhibitor to be independent risk factors for intraoperative and postoperative bleeding, respectively. Most important independent factor to determine postoperative bleeding was body weight. Of note, obese patients with low levels of PAI-1 became high-risk patients for bleeding during surgery. Our data suggest that bleeding after surgical procedure may be influenced by inter-individual differences of hemostatic function including platelet function and fibrinolysis, even in the patients without bleeding diathesis.

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The Incidence and Mortality of Thromboembolic Events in Cervical Spine Surgery

Cited by 47 publications

References 22 publications

Rapidly progressive cervical myelopathy had a high risk of developing deep venous thrombosis: a prospective observational study in 289 cases with degenerative cervical spine disease

Rapidly progressive cervical myelopathy had a high risk of developing deep venous thrombosis: a prospective observational study in 289 cases with degenerative cervical spine disease

Outpatient Cervical and Lumbar Spine Surgery is Feasible and Safe

Hemostatic function to regulate perioperative bleeding in patients undergoing spinal surgery: A prospective observational study

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