Rapidly progressive cervical myelopathy had a high risk of developing deep venous thrombosis: a prospective observational study in 289 cases with degenerative cervical spine disease

Abstract

Study design A prospective observational study. Objectives To determine the incidence of deep venous thrombosis (DVT) and to evaluate the risk factors for DVT development associated with degenerative cervical spine disease. Setting Hokkaido Spinal Cord Injury Center, Japan. Methods Between April 2008 and March 2015, patients with degenerative cervical spine disease, such as compressive myelopathy or radiculopathy, who underwent surgical treatment were prospectively assessed. Leg vein ultrasonography and D-dimer tests were performed preoperatively and at 4 days after surgery. All patients received treatment with intermittent pneumatic compression and elastic stockings for primary DVT prophylaxis. No anticoagulation medications were used for DVT prophylaxis. Results A total of 289 patients (203 males, 86 females; median age: 67 years (interquartile range, 58-76)) were included. Nine patients (3.1%) exhibited DVT during the perioperative period. All 9 cases were women who had distal DVT. The incidences of preoperative and postoperative DVT were 1.1% and 2.1%, respectively. The univariate analysis showed that statistically significant risk factors for perioperative DVT included female gender (P < 0.01), advanced age (P = 0.04), a low Japanese Orthopaedic Association score (P = 0.03), rapidly progressive myelopathy (P < 0.01), and inability to walk (P = 0.01). The multivariate analysis showed that rapidly progressive myelopathy (P = 0.04) was the most important risk factor. Conclusion Female gender and rapidly progressive myelopathy are high-risk factors that predict the development of DVT during the perioperative period of cervical spine surgery. This result indicates that screening and treatment for DVT are needed in such high-risk patients.

Identifying the Characteristics of Patients With Cervical Degenerative Disease for Surgical Treatment From 17-Year Real-World Data: Retrospective Study

“…Second, the proportion of surgeries performed among female patients showed an increasing trend over the past 17 years in this study; more female patients than male patients with CDD were admitted for inpatient surgery, and the narrowing gap between the sexes was similar to the results reported in our previous study [45]. Nevertheless, similar to the observations in other studies on cervical diseases, more surgical operations were performed among male patients than among female patients [46][47][48]. There are multiple reasons for this occurrence.…”

Prone Position Increases the Risk of Postoperative Deep Vein Thrombosis in Cervical Spine Surgery by Limiting Venous Return in the Lower Limbs

“…In this study, we retrospectively analyzed 340 patients and finally found that DVT occurred in 50 patients (14.7%), of which 45 (21.6%) occurred in prone position and five (3.9%) occurred in supine. The overall DVT incidence was relatively high compared with the literature, 1–3,8,26 which may be due to the relatively older age of the cohort with degenerative cervical spine disease, and the fact that no patients received prophylactic anticoagulant therapy preoperatively. An univariate analysis of the collected variables showed that advanced age, preoperative varicose veins in both lower extremities, high D-dimer, high BLV, prolonged operative time, more surgical segments, and surgery in the prone position may act as risk factors for the formation of DVT, which is in line with previous studies 3–6,20,27 …”

Venous thromboembolism and anticoagulation in spinal cord lesion rehabilitation inpatients: A 10-year retrospective study

“…Spinal surgery, personal or family history of VTE, smoking, and diabetes are also risk factors (Piran & Schulman, 2016;Tator et al, 1987;Wei et al, 2023). Individuals with non-traumatic SCL may be similarly at risk for VTE, which can appear before or after surgery (Chung et al, 2011;Yamada et al, 2019).…”