Uehara Masashi, Ikegami Shota, Oba Hiroki, Miyaoka Yoshinari, Hatakenaka Terue, Kurogochi Daisuke, Sasao Shinji, Mimura Tetsuhiko, Takahashi Jun
Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
Int J Spine Surg. 2024 Nov 8;18(5):457-461. doi: 10.14444/8624.
Venous thromboembolism (VTE) is a well-known complication after spine surgery. As many cases of cervical spine disease result in severe gait disturbance due to myelopathy, it may harbor a higher risk of VTE than other spinal disorders. However, few studies have focused primarily on cervical spine surgery to date. This investigation sought to determine the prevalence of VTE after cervical spine surgery and identify patient-based risk factors.
The medical data of 341 consecutive patients (240 men and 101 women; mean age, 68.1 years) who underwent cervical spine surgery were retrospectively examined. Logistic regression models were employed to examine the prevalence, characteristics, and risk factors of postoperative VTE.
In this study, 2.6% of cervical spine surgery patients experienced postoperative VTE. In comparisons of VTE and non-VTE groups, significant differences were found for age (79.6 years vs 67.7 years, < 0.01), 1-week postoperative D-dimer level (10.6 μg/mL vs 2.7 μg/mL, < 0.01), and cardiovascular disease (44.4% vs 11.1%, = 0.011). Multivariate analysis identified elevated postoperative D-dimer level and cardiovascular disease as significantly associated with postsurgical VTE with respective odds ratios of 1.54 and 9.52.
Postoperative VTE in cervical spine surgery was seen in 2.6% of cases. Patients with elevated postoperative D-dimer level and cardiovascular disease may be at increased risk of VTE and may require additional observation.
Spine surgeons should take into account that patients with elevated postoperative D-dimer levels and cardiovascular disease may be at increased risk for VTE.
静脉血栓栓塞症（VTE）是脊柱手术后一种众所周知的并发症。由于许多颈椎病病例会因脊髓病导致严重的步态障碍，所以其发生VTE的风险可能高于其他脊柱疾病。然而，迄今为止很少有研究主要聚焦于颈椎手术。本研究旨在确定颈椎手术后VTE的发生率，并识别基于患者的风险因素。
对341例连续接受颈椎手术的患者（240例男性和101例女性；平均年龄68.1岁）的医疗数据进行回顾性分析。采用逻辑回归模型来研究术后VTE的发生率、特征及风险因素。
在本研究中，2.6%的颈椎手术患者发生了术后VTE。在VTE组和非VTE组的比较中，发现年龄（79.6岁对67.7岁，P<0.01）、术后1周D-二聚体水平（10.6μg/mL对2.7μg/mL，P<0.01）和心血管疾病（44.4%对11.1%，P=0.011）存在显著差异。多因素分析确定术后D-二聚体水平升高和心血管疾病与术后VTE显著相关，其比值比分别为1.54和9.52。
颈椎手术术后VTE的发生率为2.6%。术后D-二聚体水平升高和患有心血管疾病的患者发生VTE的风险可能增加，可能需要额外观察。
脊柱外科医生应考虑到术后D-二聚体水平升高和患有心血管疾病的患者发生VTE的风险可能增加。
