Abstract:

Deep vein thrombosis and pulmonary embolus are known complications of orthopaedic procedures, particularly about the hip and knee. Spinal surgery has been associated with few thrombotic complications historically. Widespread use of instrumentation in adult patients has lead to a rise in complexity of adult spinal surgery. Length of operative procedures, level of difficulty, and bulk of instrumentation have all increased. We have noted an occasional pulmonary embolus in our center, as well as a small incidence of pulmonary embolus in recent reports of adult spine instrumented cases. A consensus conference through the National Institute of Health has estimated that between 300,000and 600,000 hospitalized patients develop deep vein thrombosis each year with as many as 50,000 deaths per year occurring secondary to pulmonary embolus. The incidence of thromboembolic disease appears to increase with age as well as with immobilization. Prolonged rest and prone positioning on frames with compression of femoral veins and iliac veins have been indicated as possible risk factors during spinal surgery.

Authors:

James L. West III, M.D., Tosh Atkins, M.D. University of South Alabama Medical Center, Mobile, AL; Lisa Helms, R.N., Orthopaedic Associates of Mobile, P.A., Mobile AL

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