Deep vein thrombosis after major spinal surgery - Incidence in an east Asian population

Study Design. A prospective study of 313 patients who underwent major spina l surgery. Objectives. To determine the incidence of deep vein thrombosis after major spinal surgery in an east Asian population without antithrombotic prophylax is. Summary of Background Data. Spinal surgery has been associated with few thr ombotic complications (2-14%) compared with other reconstructive surgeries (20-70%). It has also been well documented that the incidence of deep vein thrombosis in east Asians (10%) is lower than in westerners (20-70%) in tot al joint replacements. There has been no previous report on the incidence o f deep vein thrombosis after reconstructive spinal surgery in east Asians. Methods. Three hundred thirteen patients who underwent major spinal surgery were evaluated prospectively. All patients were examined with duplex ultra sonography assessments of both lower extremities. No specific antithromboti c prophylaxes were used in any patients before or after surgery. Results. There were four patients with positive findings of deep vein throm bosis on duplex ultrasonography, and there was only one with clinically sym ptomatic deep vein thrombosis. The overall incidence of thrombotic complica tions was 1.3%, and the incidence of symptomatic deep vein thrombosis was 0 .3%. Conclusion. Considering the low rate of deep vein thrombosis, routine scree ning and prophylaxis for deep vein thrombosis appears unwarranted in east A sians before or after major spinal surgery.