The morbidity of heparin therapy after development of pulmonary embolus in patients undergoing thoracolumbar or lumbar spinal fusion
| Autor: | James L. West, William C. Lauerman, Michael R. Major, George A. Fueredi, James E. Cain, Kirkham B. Wood |
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| Rok vydání: | 1995 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Inferior vena cava filter Vena Cava Inferior Scoliosis Thoracic Vertebrae Lumbar Postoperative Complications medicine Humans Orthopedics and Sports Medicine Aged Lumbar Vertebrae business.industry Vascular disease Heparin Anticoagulants Middle Aged Thrombophlebitis medicine.disease Surgery Pulmonary embolism Spinal Fusion Spinal fusion Orthopedic surgery Female Neurology (clinical) Morbidity business Complication Pulmonary Embolism |
| Zdroj: | Spine. 20(14) |
| ISSN: | 0362-2436 |
| Popis: | Study Design. The postoperative courses of patients who developed a pulmonary embolus after thoracolumbar or lumbar spinal fusion treated with heparin was studied to quantify the morbidity risk of anticoagulation. Objective. To compare the morbidity risk of heparinisation with that of an alternative form of therapy-inferior vena cava filter placement. Summary of Background Data. Therapeutic heparinization was the current treatment of choice for patients who develop thromboembolic disease after surgery. Although heparin usage was reported to be associated with a number of complications after other orthopedic and general surgical procedures, no information was available to identify complications of heparinization after lumbar or thoracolumbar spine surgery or to define the risk of such complications. Methods. Twenty-two members of the Scoliosis Research Society were polled to determine their experiences with the anticoagulation of this subset of patients. Surgeons polled had a combined experience of 250 man-years and had performed more than 13000 thoracolumbar and lumbar spinal fusions. The MEDLINE database was used to review pertinent English language publications describing inferior vena cava filter complications, effectiveness, safety, and indications for use. Results. Nine patients were located who fit the inlcusion criteria of this study. Six (67%) had complications attibutable to heparinization. Clinically significant complications of filter placement ranged from 0.12% to 10.1%. Conclusions. Heparinization after the development of pulmonary embolus in patients recently undergoing spinal fusion is associated with a high complication rate. The morbidity of vena cava filter placement is low and should be considred a treatment alternative in the treatmetn of patients who experience pulmonary embolus after surgery. |
| Databáze: | OpenAIRE |
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