A MULTICENTRIC RETROSPECTIVE STUDY OF THE PREVENTION OF THROMBOEMBOLIC COMPLICATIONS AFTER LUMBAR DISKECTOMY

A retrospective study of thromboembolic complications after lumbar dis c surgery has been performed. It included 16656 patients from fifty ne urosurgical units, operated on over the year 1989. The average number of operations was 333 +/- 19,5 in each unit, their average duration 55 ,2 +/- 20 minutes, and the hospital care 6,2 +/- 1,7 days. Surgery was performed using the genupectoral position in 64 % of the cases, the s upine position in 28 %, and the lateral position in 8 %. Two groups of patients have been individualized: a first group of patients with no preventive antithrombic treatment (46 % of the units) including 10 351 patients, a second group (54 % of the units) including 6 305 patients and receiving a systematic treatment with low molecular weight hepari n (4 304 patients) or calciparin (1 001 patients) or antiplatelet agen ts or pentosane polysulfate (I 000 patients). 0,63 % of the patients ( 105) had a thromboembolic accident : 0,65 % in the first group (68 cas es) and 0,58 % in the second (37 cases). No statiscally significant di fference was noticed between the two groups concerning pulmonary embol ism and/or lower-limb thrombophlebitis. Nevertheless, a prospective ra ndomized study would be usefull to corroborate this first data.