Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
World Neurosurg. 2022 Aug;164:e177-e182. doi: 10.1016/j.wneu.2022.04.064. Epub 2022 Apr 21.
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.
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.
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).
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.
静脉血栓栓塞症（VTE）包括深静脉血栓形成（DVT）和肺血栓栓塞症（PTE），是一种可能致命的有害并发症。然而，脊柱肿瘤手术后 VTE 的患病率和潜在危险因素仍未得到明确界定。
回顾性分析 96 例行脊柱肿瘤手术并术后筛查 DVT 和 PTE 的患者。我们评估了术后 VTE 与以下因素之间的关系：年龄、性别、身高、体重、体重指数、肿瘤位置、肿瘤类型（原发性或转移性）、手术类型（切除术或姑息术）、手术入路（后路或联合）、手术时间、术中出血量、围手术期输血、输血量、术后卧床休息时间（<7 天或>7 天）、术前瘫痪、术后瘫痪和术后神经恶化。
总体 VTE 患病率为 25.0%（24/96）。DVT 和 PTE 的发生率分别为 20.8%（20/96）和 6.3%（6/96）。6 例 PTE 阳性患者中仅 4 例为单纯 PTE，2 例为 PTE 和 DVT 并存。单因素分析显示，VTE 组的术后卧床休息时间明显长于非 VTE 组（P=0.03）。多因素分析显示，只有延长的术后卧床休息时间是独立的显著危险因素（P=0.036）。
脊柱肿瘤手术后 VTE 的患病率为 25.0%。延长的术后卧床休息时间是术后 VTE 的危险因素。6 例 PTE 阳性患者中有 4 例未发现 DVT，提示在 VTE 高危病例中也需要对 PTE 本身进行筛查。
