Koji Akeda, MD, PhD, from the Mie University Graduate School of Medicine in Japan, and colleagues conducted prospective follow-up on 209 patients undergoing spinal surgery (121 males, 88 females; average age, 64 years) who had ultrasonographic assessments of both legs before and after surgery. For primary VTE prophylaxis, a pneumatic sequential compression device and standard compression stockings were used. Pharmacological agents were not used for VTE prophylaxis unless a distal type deep venous thrombosis (DVT) was found preoperatively.
The researchers found that 23 patients (11.0%) showed VTE in the spinal surgery perioperative period. Before surgery, nine patients (4.3%) had VTE (pulmonary embolism [PE] with proximal DVT, one; distal DVT, eight). New-onset VTE developed in 14 patients (6.7%; two PE with proximal DVT; 12 distal DVT) after spinal surgery. Two patients developed new-onset PE with proximal DVT after surgery. DVT disappeared (based on follow-up ultrasonography) completely in 85% of patients with a distal type DVT (17 of 20).
“DVT assessment using ultrasonography is important for proper management of VTE during the perioperative period of spinal surgery, especially for high-risk patients, such as those with advanced age or neurological deficit,” the authors write.