Venous Thromboembolism After Spine Surgery: A5 Year Experience
Rema Malik, M.D..
Wayne State University, Detroit, MI, USA.
OBJECTIVES - The purpose of this study is to highlight the five year experience of a single surgeon in venous thromboembolism after retroperitoneal spine exposures. METHODS - We performed a retrospective 5 year review of all the operations performed at the two major hospitals a single vascular surgeon is based out of. The operations that included “ascending venography,” “iliac vein stenting,” and “Venogram” were reviewed from 9/2015 to 9/2020. Patients who had a previous spine intervention provoking venous thromboembolism were included. RESULTS - We present four patients who developed venous thromboembolism after spine surgery. A 65-year-old female with a history of multiple sclerosis, recently plagued with a pericarditis and pericardial effusion resulting in symptoms of congestive heart failure and edema in her lower extremities related to thrombosed inferior vena cava filter, through which a Z stent was placed and has had subsequent venous interventions to maintain patency. A 74 year old female with neurogenic claudication underwent bilateral decompressive lumbar laminectomy L4-5, L5-S1 and posterolateral fusion, L3-S1, and presented with extensive left lower extremity deep vein thrombosis (DVT) in the iliofemoral and popliteal veins, threated with thrombolysis and venous stenting. A 70 year old male with previous DVT and pulmonary embolism underwent extensive lumbar spine surgical fusion and presented with 1 week history of left lower extremity edema and pain with extensive left iliofemoral deep vein thrombosis. He was found to have extrinsic compression of the left common iliac vein from his hardware, and after mechanical thrombectomy and lytic therapy, he underwent Intravenous ultrasonography (IVUS) with iliac vein stenting. A 79 year old female underwent a lumbar laminectomy 6 weeks prior to presentation of acute thrombosis of left femoropopliteal veins, treated with lysis and balloon angioplasty with stenting of left iliac vein.CONCLUSIONS - Lumbar spine surgery is a known independent risk factor for development of deep vein thrombosis, and we highlight a rare case of extrinsic compression of the left iliac vein from the hardware resulting in deep vein thrombosis.
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