|
KMID : 0980120180160020049
|
|
Annals of Phlebology
2018 Volume.16 No. 2 p.49 ~ p.52
|
|
|
Safety and Effectiveness of Combined Chemical and Mechanical Prophylaxis for Deep Vein Thrombosis after Spinal Fusion Surgery
|
|
Kim Min-Gyu
Kim Kyung-Yun
|
|
|
Abstract
|
|
|
Objective: Deep vein thrombosis (DVT) is one of the most frequent complications in patients undergoing spinal fusion surgeries. In the era of orthopedic surgery, a consensus does exist on DVT prophylaxis. But, unfortunately, in spinal surgeries, this topic remains controversial. In the present study, we investigated the incidence of DVT in patients receiving combined prophylactic therapies (chemical and mechanical prophylaxis) after spinal fusion surgery. The safety of chemical prophylaxis for these patients was also assessed.
Methods: This prospective cross sectional study was conducted during 10-month period from March 2017 to December 2017. 60 patients who underwent elective spinal fusion surgery and underwent combined prophylactic therapies (low-molecular weight heparin [LMWH] and intermittent pneumatic compression [IPC]) were included. Before surgery, the risk factors for DVT were assessed according to the American College of Chest Physicians guideline 9th edition (ACCP-9). Enoxaparine was injected subcutaneously twice a day at the first postoperative day and continued daily until the patient was ambulating well. Also, all patients received mechanical prophylaxis using an IPC device (DVT-3000: DS MAREF, Korea) for the time during the postoperative immobilization. Doppler ultrasonography was performed before discharge to detect asymptomatic DVT.
Results: The mean age of the patients was 72.1±6.7 years including 21 (35%) men and 39 (65%) women. According to the ACCP-9 guideline, all patients were classified as high-risk group. Spinal interbody fusions were performed at a single level for 24 (40%), two levels for 20 (33.3%), three levels for 9 (15%), four levels for 5 (8.3%), five levels for 1 (1.7%), and six levels for 1 (1.7%) patients. No adverse events such as bleeding were recorded among the patients. Only one (1.6%) patients developed DVT
Conclusions: This study show that combined prophylactic methods can be effective in preventing DVT after spinal fusion surgery, without increasing the rate of bleeding complications. But, further well-controlled prospective studies are needed to confirm this result.
|
|
|
KEYWORD
|
|
|
Deep vein thrombosis, Spinal fusion surgery, Prophylaxis, Low molecular weight heparin
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|