Prevention of deep-vein thrombosis after major spinal surgery: a comparison study of external devices.

We studied the difference in postoperative thrombotic complications after major spinal surgery between two commonly used external compression devices. Our 136 subjects were prospectively randomized to receive either thigh-high sequential pneumatic compression wraps or pneumatic foot-compression wraps. All were studied postoperatively with duplex ultrasonography and analyzed for leg swelling, the rate of thrombotic events, and overall subjective patient comfort. The rate of postoperative thrombosis was 1.5%. The one pulmonary embolism was successfully treated with heparin. One other patient had a small asymptomatic thrombus of the saphenous vein. Both subjects wore foot wraps. Subjectively, the devices were rated as being equally comfortable. We believe that external compression for thrombosis prophylaxis after major spinal surgery is effective. The particular device chosen may be driven by other factors such as cost, physician or nursing preference, and ease of application.