Prevention of Thromboembolic Complications After Spine Surgery by the Use of Low-Molecular-Weight Heparin.

Abstract

This study aimed to evaluate the effectiveness and safety of the use of low-molecular-weight heparin (LMWH) in the prevention of thromboembolic complications after spine surgery. We conducted a retrospective study on 2 groups of patients receiving spine surgery. A total of 947 patients admitted for surgery from July 2009 to June 2012 were administered therapeutic dose of LMWH daily after the surgery (therapeutic group). Another 814 patients enrolled from July 2006 to June 2009 were not given any heparin treatment (control group). The wound drainage volume, the incidence rate of thrombosis and thromboembolic complications, and the occurrence of bleeding complications in 2 groups were statistically compared. The therapeutic group showed a lower rate of postsurgery thromboembolic complications when compared with the control group (therapeutic group, 0.21%; control group, 1.6%; P = 0.002). Among the individual type of complications, the occurrence of cerebral infraction was the most significantly reduced (P = 0.005). The overall rate of bleeding complications was higher in the therapeutic group compared with the control group, and the difference was marginally insignificant (therapeutic group, 1.8%; control group, 0.74%; P = 0.051). The use of LMWH significantly decreases the incidence of thrombosis and thromboembolic complications after spine surgery, but increase the incision bleeding, leading to an elevated risk of symptomatic spinal epidural hematoma.