The Spine Journal
Volume 9, Issue 12 , Pages 1046-1051 , December 2009

An evidence-based clinical guideline for the use of antithrombotic therapies in spine surgery

  • Christopher M. Bono, MD

      Affiliations

    • Department of Orthopedic Surgery, Brigham & Women's Hospital, 75 Francis St, Boston, MA 02115-6110, USA
    • Corresponding Author InformationCorresponding author. Department of Orthopedic Surgery, Brigham & Women's Hospital, 75 Francis St, Boston, MA 02115-6110, USA. Tel.: (617) 732-7238; fax: (617) 732-6937.
    • ,
  • William C. Watters III, MD

      Affiliations

    • Bone & Joint Clinic of Houston, 6624 Fannin St, Ste 2600, Houston, TX 77030-2338, USA
    • ,
  • Michael H. Heggeness, MD, PhD

      Affiliations

    • Orthopedic Department, Baylor College of Medicine, 1709 Dryden Rd, Ste 1230, Houston, TX 77030-2400, USA
    • ,
  • Daniel K. Resnick, MD

      Affiliations

    • Department of Neurosurgery, University of Wisconsin Medical School, 600 Highland, K4/834 Clinical Science Center, Madison, WI 53792-0001, USA
    • ,
  • William O. Shaffer, MD

      Affiliations

    • University of Kentucky, 740 S Limestone St, Kentucky Clinic K-416, Lexington, KY 40536-0001, USA
    • ,
  • Jamie Baisden, MD

      Affiliations

    • Department of Neurosurgery, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522, USA
    • ,
  • Peleg Ben-Galim, MD

      Affiliations

    • Orthopedic Department, Baylor College of Medicine, 1709 Dryden Rd, Ste 1230, Houston, TX 77030-2400, USA
    • ,
  • John E. Easa, MD

      Affiliations

    • Michigan Medical, PC, 12662 Riley St, Ste 120, Holland, MI 49424-8023, USA
    • ,
  • Robert Fernand, MD

      Affiliations

    • North Jersey Medical Village, 516 Hamburg Turnpike, Wayne, NJ 07470-2062, USA
    • ,
  • Tim Lamer, MD

      Affiliations

    • Mayo Clinic Rochester, 200 1st St SW, Charlton 1-145, Rochester, MN 55905-0001, USA
    • ,
  • Paul G. Matz, MD

      Affiliations

    • Neurosurgery & Neurology, LLC, 232 S Woods Mill Rd, Suite 400E, Chesterfield, MO 63017-3417, USA
    • ,
  • Richard C. Mendel, MD

      Affiliations

    • South Florida Neurosurgery, 4290 Professional Center Dr, Ste 105, Palm Beach Gardnes, FL 33410-4275, USA
    • ,
  • Rajeev K. Patel, MD

      Affiliations

    • University of Rochester Spine Center, 322 Sandringham Rd, Rochester, NY 14610-3456, USA
    • ,
  • Charles A. Reitman, MD

      Affiliations

    • Orthopedic Department, Baylor College of Medicine, 1709 Dryden Rd, Ste 1230, Houston, TX 77030-2400, USA
    • ,
  • John F. Toton, MD

      Affiliations

    • 1310 Prentice Dr, Ste G, Healdsburg, CA 95448-5005, USA

Received 29 May 2009 ,Revised 17 September 2009 ,Accepted 17 September 2009.

References 

  1. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: Institute of Medicine; 2001;
  2. Heffner JE. Does evidence-based medicine help the development of clinical practice guidelines?. Chest. 1988;113(3 Suppl):172S–178S
  3. Murphy MK, Black LA, Lamping DL, et al. Consensus development methods, and their use in clinical guideline development. Health Technol Assess. 1998;2:31–88
  4. Gruber UF, Rem J, Meisner C, Gratzl O. Prevention of thromboembolic complications with miniheparin-dihydroergotamine in patients undergoing lumbar disc operations. Eur Arch Psychiatry Neurol Sci. 1984;234:157–161
  5. Joffe SN. Incidence of postoperative deep vein thrombosis in neurosurgical patients. J Neurosurg. 1975;42:201–203
  6. Lee HM, Suk KS, Moon SH, et al. Deep vein thrombosis after major spinal surgery: incidence in an East Asian population. Spine. 2000;25:1827–1830
  7. Oda T, Fuji T, Kato Y, et al. Deep venous thrombosis after posterior spinal surgery. Spine. 2000;25:2962–2967
  8. Uden A. Thromboembolic complications following scoliosis surgery in Scandinavia. Acta Orthop Scand. 1979;50:175–178
  9. Rokito SE, Schwartz MC, Neuwirth MG. Deep vein thrombosis after major reconstructive spinal surgery. Spine. 1996;21:853–858discussion 859
  10. Wood KB, Kos PB, Abnet JK, Ista C. Prevention of deep-vein thrombosis after major spinal surgery: a comparison study of external devices. J Spinal Disord. 1997;10:209–214
  11. Nelson LD, Montgomery SP, Dameron TB, Nelson RB. Deep vein thrombosis in lumbar spinal fusion: a prospective study of antiembolic and pneumatic compression stockings. J South Orthop Assoc. 1996;5:181–184
  12. Deep K, Jigajinni MV, McLean AN, Fraser MH. Prophylaxis of thromboembolism in spinal injuries—results of enoxaparin used in 276 patients. Spinal Cord. 2001;39:88–91
  13. Gerlach R, Raabe A, Beck J, et al. Postoperative nadroparin administration for prophylaxis of thromboembolic events is not associated with an increased risk of hemorrhage after spinal surgery. Eur Spine J. 2004;13:9–13
  14. Voth D, Schwarz M, Hahn K, et al. Prevention of deep vein thrombosis in neurosurgical patients: a prospective double-blind comparison of two prophylactic regimen. Neurosurg Rev. 1992;15:289–294

 This review article summarizes a published evidence-based guideline. It is a product of the NASS Evidence-based Guideline Development Committee, approved by the NASS Board of Directors and accepted for publication outside The Spine Journal's peer review process.

 FDA device/drug status: not applicable.

 Author disclosures: CMB (royalties, Life Spine; consulting, DePuy Spine, Medtronic Sofamor Danek; speaking/teaching arrangements, DePuy Spine, Stryker Spine; board of directors, North American Spine Society; other office, Applied Spine; staff/materials, Archus Orthopedics, Synthes Spine; grants, Stryker Spine; fellowship support, DePuy Spine); WCW (consulting, Stryker; scientific advisory board, Intrinsic Therapeutics; other, Blaskstone Medical, Inc.); MHH (royalties, stock ownership, consulting, scientific advisory board, Relievant Medsystems; investigator salary, Department of Defense); DKR (consultant [NASS Spring Break], Medtronic); WOS (consulting, royalties [Upcoming Committee Meeting], DePuy Spine; trips/travel, BrainLab); PGM (stock ownership, Alkermes Corporation, Schering Plough; consulting, Synthes; speaking/teaching arrangements, AO/ASIF; grants, Medtronic).

PII: S1529-9430(09)00960-7

doi: 10.1016/j.spinee.2009.09.005

The Spine Journal
Volume 9, Issue 12 , Pages 1046-1051 , December 2009

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