Venous Thromboembolism Prophylaxis for Patients Having Elective Spine Surgery: When, Why, and How Much

Abstract

The prevalence of venous thromboembolism (VTE) events varies widely following elective spine surgery, with reported rates ranging from 0.21% to 13.6%. Risk factors for the development of VTE after spine surgery include patient or family history, obesity, longer operative time, manipulation of the great vessels, and decreased mobility postoperatively. There is limited consensus regarding the selection and initiation of postoperative chemoprophylaxis, which should be implemented thoughtfully because of the bleeding risk and, specifically, the development of epidural hematoma. Prophylactic use of inferior vena cava filters in low-risk patients having elective spine surgery has not been well supported in the literature. Further investigation is needed to determine its utility as an additional modality to prevent postoperative pulmonary embolus in elective spine surgery.