DOES CERVICAL SPINAL-CORD INJURY INDUCE A HIGHER INCIDENCE OF COMPLICATIONS AFTER PROPHYLACTIC GREENFIELD INFERIOR VENA-CAVA FILTER USAGE

PURPOSE: To determine whether acute cervical spine injury represents a risk factor for complications from prophylactic placement of current generation Greenfield inferior vena cava (IVC) filters, MATERIALS AND METHODS: A retrospective chart review performed during a 7-year period identified 11 patients with acute cervical spinal cord injuries who u nderwent prophylactic Greenfield NC filter insertion, Specific complic ations evaluated included symptomatic pulmonary embolism (PE), migrati on, filter base diameter changes, caval perforation, and thrombosis, T he amount of migration and changes in filter base dimension were compa red statistically with a control population of IVC filter patients (n = 16) without cervical spine injuries, RESULTS: Filter migration (>10 mm) was the most common complication (46%), Migration usually is cauda lly directed (64%), may occur early (36% moved >10 mm within a 30-day period), and is often asymptomatic, The prevalence of filter migration greater than 30 mm was 27%, The average amount of migration for the s ubpopulation under study was greater than that seen with the control p opulation (P < .05), No statistically significant change in filter bas e size occurred, The study population also had rates of PE (9%-18%), c aval perforation (9%), and NC thrombus formation (18%) that were highe r than the rates in historical controls, The majority of patients with these complications received vigorous pulmonary toilet (46%), includi ng ''quad coughs'' or cardiopulmonary resuscitation (18%), CONCLUSIONS : Acute cervical spinal cord injury and the associated supportive care may be associated with an increased risk for caudal NC filter migrati on, IVC perforation, caval thrombosis, and PE.