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The Rate of Venous Thromboembolism Before and After Spine Surgery as Determined with Indirect Multidetector CT

Inoue, Hirokazu, MD, PhD1; Watanabe, Hideaki, MD, PhD2; Okami, Hitoshi, MD, PhD3; Kimura, Atsushi, MD, PhD1; Takeshita, Katsushi, MD, PhD1

doi: 10.2106/JBJS.OA.18.00015
Scientific Articles: PDF Only

Background: This prospective cohort study investigated the rate of venous thromboembolism (VTE) before and after spine surgery as determined with use of indirect multidetector computed tomography (MDCT).

Methods: We performed a prospective study of 105 patients (36 women and 69 men ranging in age from 38 to 88 years) undergoing spine surgery at 2 institutions. Indirect MDCT was performed before and 3 days after surgery. Patients with a history of dialysis or drug allergy to contrast medium were excluded.

Results: No patient had symptomatic VTE preoperatively or postoperatively. The preoperative and postoperative rates of asymptomatic VTE were 4.8% and 13.0%, respectively; the rates of asymptomatic pulmonary embolism were 2.9% and 8.0%, respectively; and the rates of asymptomatic deep venous thrombosis were 3.8% and 6.0%, respectively. Age, sex, height, weight, body mass index, operative time, volume of intraoperative blood loss, and specific comorbidities (diabetes, hypertension, cardiac disease, previous VTE, and previous anticoagulation treatment) were not found to be risk factors.

Conclusions: Our findings demonstrated a low rate of preoperative VTE but a high rate of postoperative VTE in association with spine surgery. Surgeons need to be aware of the risk of VTE in patients undergoing spine surgery. MDCT is an effective and convenient technology for the early detection of VTE in such patients.

Level of Evidence: Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

1Department of Orthopaedic Surgery, Jichi Medical University, Shimotsuke, Japan

2Department of Pediatric Orthopaedic Surgery, Jichi Children’s Medical Center, Shimotsuke, Tochigi, Japan

3Department of Orthopaedic Surgery, Shinkaminokawa Hospital, Kaminokawa, Japan

E-mail address for H. Inoue:

Investigation performed at Jichi Medical University, Shimotsuke, Japan, and Shinkaminokawa Hospital, Kaminokawa, Japan.

Disclosure: There was no external source of funding for this study. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

© 2018 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The Journal of Bone and Joint Surgery, Incorporated.