Incidence of deep vein thrombosis after major spine surgeries with no mechanical or chemical prophylaxis

Abstract

Study design: Retrospective cohort study.Clinical question: What is the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) after major spine surgery when no prophylactic measures were used?Methods: A prospective evaluation of 121 patients who underwent 128 major spine surgeries was conducted to determine the incidence of clinically identifiable DVT. As a matter of practice, no patient was given thromboprophylaxis, either mechanical or chemical.Results: Only one patient developed the signs and symptoms of DVT, which was further confirmed by a Doppler study. The overall incidence of DVT was 0.78%. There was no clinically evident case of PE.Conclusions: Considering the low rate of incidence of DVT and PE, routine screening and prophylaxis for DVT appears unwarranted in major spine surgery.Final class of evidence—prognosisStudy design Prospective cohort Retrospective cohort• Case control Case seriesMethods Patients at similar point in course of treatment• F/U ≥ 85% Similarity of treatment protocols for patient groups• Patients followed up long enough for outcomes to occur• Control for extraneous risk factorsOverall class of evidenceIIIThe definiton of the different classes of evidence is available on page 63.