Analysis of risk factors for deep vein thrombosis after lumbar endoscopic single-segment decompression without fusion.

Abstract

STUDY DESIGN: This study was a retrospective review. OBJECTIVE: To investigate the risk factors of deep vein thrombosis (DVT) after lumbar endoscopic single-segment decompression without fusion. METHODS: This retrospective study was conducted on patients who underwent lumbar endoscopic single-segment decompression without fusion at one institution between January 2025 and June 2025. Date on age, gender, Body Mass Index (BMI), hypertension, diabetes, smoking, drinking, lower limb muscle strength, preoperative mean arterial pressure (PMAP), lumbar operation segment, operation duration, intraoperative blood loss, intraoperative fluid infusion, intraoperative mean arterial pressure (IMAP) and postoperative laboratory indicators such as blood C-reactive protein (CRP) and D-dimer levels at admission and on the first postoperative day were collected. DVT was diagnosed through lower limbs venous ultrasound screening within three days after the operation. Univariate analysis was performed to identify the influencing factors of DVT, and then logistic regression was used to find out the independent risk factors. The Receiver Operating Characteristic (ROC) curve and area under the curve (AUC) were used to analyze the factors predicting DVT after lumbar endoscopic surgery. RESULTS: A total of 176 patients who underwent single-segment decompression without fusion via lumbar endoscopy were included in this study, and early postoperative DVT was identified in 37 patients, resulting in a DVT rate of 21%. Between the DVT and non-DVT groups, there were significant differences in age, gender, BMI, smoking, hypertension, IMAP, admission D-dimer, postoperative CRP, and postoperative D-dimer levels. The logistic regression analysis found that age and admission D-dimer were independent risks for DVT. The ROC curve showed that the AUC of age was 0.782, with a cut-off value was 59.5 years (sensitivity: 89.2%, specificity: 60.4%). The AUC of admission D-dimer was 0.738, with a cut-off value was 243.5 ng/mL (sensitivity: 48.6%; specificity: 93.8%). CONCLUSION: Age and admission D-dimer are independent correlative factor for early DVT after lumbar endoscopic single-segment decompression without fusion, and patients over 60 years old with admission D-dimer higher than 243.5 ng/ml have a higher risk of DVT in the early postoperative period and our research provides clinical guidance for the risk factors of DVT formation after lumbar endoscopic surgery.