Prevalence of Asymptomatic Deep Vein Thrombosis in Preoperative State of Spine Surgeries

Abstract

Deep venous thrombosis (DVT) is considered the most common cause of preventable death among hospitalized patients. A few studies have investigated the risk of venous thromboembolic events (VTE) in patients undergoing elective spine surgery and reported varying incidences. We aim to assess the incidence of preoperative lower limb DVT in lumbar degenerative disease patients undergoing elective surgery. This is a retrospective review of prospectively collected data on adult patients with lumbar degenerative spine diseases (lumbar stenosis; LST, lumbar spondylolisthesis; SPL, or lumbar disc herniation; LDH) who were scheduled for operative management. Each patient underwent a preoperative lower limb venous Duplex (LLVD). Incidence of DVT, risk factors, and clinical course of patients were reported. Forty-nine patients (32 females; 65%) were included. All patients were diagnosed clinically and radiologically with lumbar degenerative diseases; LST (44.9%), SPL (36.7%), and LDH (18.4%), requiring surgical management. Three patients (6.1%) were found to have positive DVT studies, leading to the cancellation or rescheduling of their procedures (p < 0.01). These included one patient with LST (p = 0.045) and two patients with SPL (p = 0.006). Among patients with LST and SPL, higher disability (modified Rankin scale; mRS ≥3) was significantly associated with positive LLVD (p = 0.035). Patients with LST or SPL with higher preoperative disability scores were at higher risk to have preoperative DVT. Further research is needed to evaluate the feasibility and value of preoperative LLVD to detect DVT in patients planned for lumbar degenerative surgery.