Pulmonary embolism and deep venous thrombosis after spinal surgery

The incidence of pulmonary embolism (PE) and deep venous thrombosis (DVT) in 36 patients after lumbar spinal surgery was investigated. Anterior spinal fusion (ASF) had been performed in 6 cases, fenestration in 20 cases, and posterior interbody fusion (PLIF) in 10 cases. Fenestration and PLIF were performed in the prone position. PE was diagnosed by lung perfusion scans, and DVT on the basis of clinical signs. The blood gas analysis data and serum thrombin anti-thrombin III complex (TAT) and D-dimer levels were examined following surgery. PE and symptomatic DVT had occurred in each 2 cases (5.6%). Although PE cases were asymptomatic, the PaO2 level decreased 20% on postoperative day 7, and D-dimer was significant increased on postoperative day 14. It should be noted that PE and DVT are not very rare after spinal surgery, and it is important to diagnose them earlier and to prevent them. Blood gas analysis and determination of D-dimer levels after spinal surgery are useful for early detection of PE. (author)