Prevalence and Risk Factors for the Development of Venous Thromboembolism After Spinal Tumor Surgery

OBJECTIVE: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE), is a deleterious complication that can be fatal. However, the prevalence and underlying risk factors for VTE after spinal tumor surgery remain poorly defined. METHODS: Ninety-six patients undergoing spinal tumor surgery with postoperative screening for DVT and PTE were reviewed. We evaluated the relationship between postoperative VTE and the following factors: age, sex, height, weight, body mass index, location of the tumor, type of tumor (primary or metastasis), type of operation (excisional surgery or palliative surgery), surgical approach (posterior or combined), operative time, intraoperative blood loss, perioperative transfusion, amount of transfusion, duration of postoperative bed rest (<7 days or >7 days), preoperative paralysis, postoperative paralysis, and postoperative neurological worsening. RESULTS: The overall prevalence of VTE was 25.0% (24/96). The rate of DVT and PTE was 20.8% (20/96) and 6.3% (6/96), respectively. PTE only was identified in 4 of 6 PTE-positive patients, and both PTE and DVT were identified in 2. In univariate analysis, the duration of postoperative bed rest of the VTE group was significantly longer than that of the non-VTE group (P = 0.03). In multivariate analysis, only prolonged duration of postoperative bed rest was a significant independent risk factor (P = 0.036). CONCLUSIONS: The prevalence of VTE after spinal tumor surgery was 25.0%. Prolonged duration of postoperative bed rest was a risk factor for postoperative VTE. No DVT was found in 4 of 6 PTE-positive patients, suggesting that screening for PTE itself is also needed in high-risk cases of VTE.