Thromboembolism After Intramedullary Nailing for Metastatic Bone Lesions

Shallop, Brandon; Starks, Alexandria; Greenbaum, Simon; Geller, David S.; Lee, Alan; Ready, John E.; Merli, Geno J.; Maltenfort, Mitchell; Abraham, John A.

doi:10.2106/jbjs.n.01067

Cited by 27 publications

(24 citation statements)

References 41 publications

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“…We also observed that symptomatic VTE timing exceeded hospitalization in fatal PEs (respectively, 24; IQR, 11-41 versus 14; IQR, 9-20). Similar studies have reported comparable results about this late onset of symptomatic VTE [9,19,28,36,39,42]. Both institutions followed protocols that recommend postoperative anticoagulant regimens of about 4 weeks, but considering the late onset of symptomatic VTE, a longer duration of anticoagulant use may be indicated [19,39,41].…”

Section: Discussionmentioning

confidence: 68%

“…Another, similar study reported a symptomatic VTE in 1.6% of patients undergoing surgery for symptomatic spinal metastases, but this study was designed to determine survival and not specifically evaluate the risk of symptomatic VTE [3]. Compared with similar VTE studies for spine and musculoskeletal tumor surgery, the findings are relatively high; particularly, the number of fatal PEs is unprecedented [5,9,17,19,27,28,30,32,36,39,42]. Multiple factors might explain the high risk of symptomatic VTE observed here, including older age, neoplasm, severe venous stasis, prolonged immobilization and paralysis postoperatively, as well as longer operation times [1,15,17].…”

Section: Discussionmentioning

confidence: 95%

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High Risk of Symptomatic Venous Thromboembolism After Surgery for Spine Metastatic Bone Lesions: A Retrospective Study

Groot

Ogink

Pereira

et al. 2019

Clin Orthop Relat Res

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Background Cancer and spinal surgery are both considered risk factors for venous thromboembolism (VTE). However, the risk of symptomatic VTE for patients undergoing surgery for spine metastases remains undefined. Questions/purposes The purposes of this study were to: (1) identify the proportion of patients who develop symptomatic VTE within 90-days of surgical treatment for spine metastases; (2) identify the factors associated with the development of symptomatic VTE among patients receiving surgery for spine metastases; (3) assess the association between the development of postoperative symptomatic VTE and 1-year survival among patients who underwent surgery for spine metastases; and (4) assess if chemoprophylaxis increases the risk of wound complications among patients who underwent surgery for spine metastases. Methods Between 2002 and 2014, 637 patients at two hospitals underwent spine surgery for metastases. We considered eligible for analysis adult patients whose procedures were to treat cervical, thoracic, or lumbar metastases (including lymphoma and multiple myeloma). At followup after 90 days and 1 year, respectively, 21 of 637 patients (3%) and 41 of 637 patients (6%) were lost to followup. In general, we used 40 mg of enoxaparin or 5000 IUs subcutaneous heparin every 12 hours. Patients on preoperative chemoprophylaxis continued their initial medication postoperatively. All chemoprophylaxis was started 48 hours after surgery and continued day to day but was discontinued if a bleeding complication developed. Low-molecular-weight heparin (including enoxaparin and dalteparin, in general dosages of respectively 40 mg and 5000 IUs daily) was the most commonly used chemoprophylaxis in 308 patients (48%). Subcutaneous heparin was injected into 127 patients (20%); aspirin was used for 92 patients (14%); and warfarin was administered in 21 Each author certifies that neither he, nor any member of his immediate family, have funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Clinical Orthopaedics and Related Research® neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use. Each author certifies that his institution approved the reporting of this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 95%

High Risk of Symptomatic Venous Thromboembolism After Surgery for Spine Metastatic Bone Lesions: A Retrospective Study

Groot

Ogink

Pereira

et al. 2019

Clin Orthop Relat Res

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“…Interestingly, our study showed that lung cancer patients experienced the greatest number of intraoperative saturation drops and PE cases compared to patients with other primary cancers. The increased risk of VTE for lung cancer patients has already been described in the literature [24,26] as is their poor survival following surgery to remove skeletal metastases [27]. These adverse outcomes might reflect the strong association between thromboembolic events after surgical treatment of skeletal metastases.…”

Section: Discussionmentioning

confidence: 91%

“…In addition, the operative nailing method was also associated with decreased survival. First, intramedullary nailing itself appears to carry a risk for VTE [24], thereby contributing to decreased survival. Second, when performing intramedullary nailing, the removal of a tumour with marginal resection cannot be achieved.…”

Section: Discussionmentioning

confidence: 99%

Venous thromboembolism after surgical treatment of non-spinal skeletal metastases — An underdiagnosed complication

Ratasvuori

Lassila

Laitinen

2016

Thrombosis Research

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“…Metastatik kırıklar, özellikle de akciğer kaynaklı olanlar, yüksek tromboz riski ile ilişkilidir; bu nedenle, profilaktik antitrombotik tedavi düzenlenmelidir. [16] Hastaların hayatta kalma süreleri kısa olması nedeniyle, cerrahi sonrası ekstremitenin bir an önce günlük hayata uygun şekilde fonksiyonellik kazanması ve üstüne yük verilebilir hale gelmesi önemlidir. [17] Bu yüzden; tedavi planı içerisinde kemik iyileşmesi, allogreft kaynaması, stem veya kapların yüzeylerine kemik doku ilerlemesi gibi normal iyileşme prosedürleri daha az olmalı, bunun yerine çimentolu implantlar tercih edilmelidir.…”

Section: Tedaviunclassified

Uzun kemik diyafizer metastazları

Başarır¹,

Karaca²

2019

TOTBID

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ve yumuşak doku sarkomlarında görülmüştür. [2][3][4][5] Kemik metastazı olduktan sonraki beklenen yaşam süreleri; melanomada 6 ay, akciğer kanserinde 6-7 ay, mesane kanserinde 6-9 ay, böbrek hücreli kanserde 12 ay, prostat kanserinde 12-53 ay, meme kanserinde 19-25 ay ve tiroid kanserinde 48 aydır. [6] Metastatik tutulum oranları vertebrada %69, pelviste %41, femurda %25, üst ekstremitelerlerde %15, kraniyumda %14 olarak bulunmuştur. KEMİK METASTAZLARIKemik, akciğer ve karaciğerden sonra en sık metastaz olan üçüncü dokudur. Diğer yandan, kemik metastazları kemik dokunun en sık görülen malign tümörüdür.Kemik metastazları sıklıkla prostat (%34), meme (%22) ve akciğer (%20) tümörlerinden kaynaklanır. [1] Kemik metastazları daha az sıklıkta tiroid kan-

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Thromboembolism After Intramedullary Nailing for Metastatic Bone Lesions

Cited by 27 publications

References 41 publications

High Risk of Symptomatic Venous Thromboembolism After Surgery for Spine Metastatic Bone Lesions: A Retrospective Study

High Risk of Symptomatic Venous Thromboembolism After Surgery for Spine Metastatic Bone Lesions: A Retrospective Study

Venous thromboembolism after surgical treatment of non-spinal skeletal metastases — An underdiagnosed complication

Uzun kemik diyafizer metastazları

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