Evidence-Based Clinical Guidelines
Multidisciplinary Spine Care Antithrombotic Therapies for Adults Undergoing Spine Surgery
Second Edition
Recommendations:
Incidence of VTE without Prophylaxis
Key Recommendations:
Because of the widespread use of VTE prophylaxis across all surgical disciplines, it is not possible to make a determination regarding the value of prophylaxis versus no prophylaxis and the author group does not believe that such a study would be ethically possible. The major finding from this portion of the review is that VTE prophylaxis is safe and that differences in efficacy between different strategies are small.
Question 1: What is the incidence (symptomatic and asymptomatic) and timing of venous thromboembolism (VTE) following elective spinal surgery not performed for tumor or trauma (cervical, thoracic or lumbar) without any form of prophylaxis?
A systematic review of the literature yielded no studies to adequately address this question.
Work Group Narrative
The incidence of VTE in patients undergoing elective spine surgery without prophylaxis is difficult to determine because of the variability in diagnostic criteria used and the testing mechanisms employed.
Future Directions for Research
The work group has no recommendations for future research into the effect of withholding mechanical or chemical prophylaxis.
Question 2: What is the incidence (symptomatic and asymptomatic) and timing of venous thromboembolism (VTE) following spinal surgery (cervical, thoracic or lumbar) for spine trauma (with spinal cord injury and without spinal cord injury) without any form of prophylaxis?
A systematic review of the literature yielded no studies to adequately address this question.
Work Group Narrative
The incidence of VTE in patients undergoing spine surgery for trauma is difficult to determine because of the variability in diagnostic criteria used and the testing mechanisms employed.
Future Directions for Research
The work group has no recommendations for future research into the effect of withholding mechanical or chemical prophylaxis.
Question 3: What is the incidence (symptomatic and asymptomatic) and timing of venous thromboembolism (VTE) following spinal surgery (cervical, thoracic or lumbar) for malignancy (with spinal cord injury and without spinal cord injury) without any form of prophylaxis?
A systematic review of the literature yielded no studies to adequately address this question.
Work Group Narrative
The incidence of VTE in patients undergoing spine surgery for tumor is difficult to determine because of the variability in diagnostic criteria used and the testing mechanisms employed.
Future Directions for Research
The work group has no recommendations for future research into the effect of withholding mechanical or chemical prophylaxis.