Examining the frequency and factors related to the occurrence of deep vein thrombosis (DVT) in patients undergoing posterior fixation of the lumbosacral spine (PSF).

BACKGROUND

Posterior spinal fixation (PSF) of the lumbosacral region is a commonly performed procedure for managing various spinal pathologies. Deep vein thrombosis (DVT) is a potential complication that can lead to serious outcomes such as thromboembolism. This study aimed to determine the prevalence of DVT and identify associated risk factors in patients undergoing lumbosacral PSF at Firoozgar Hospital, Tehran.

METHODS

This prospective cohort study included patients who underwent lumbosacral PSF for degenerative diseases or trauma. All participants underwent lower limb color Doppler ultrasonography before surgery to rule out preexisting DVT. Postoperatively, they were monitored for clinical signs of DVT for two weeks and underwent a follow-up Doppler ultrasound. Demographic and clinical data were collected and analyzed using univariate and multivariate statistical methods to identify risk factors associated with DVT.

RESULTS

DVT occurred in 5 of 109 patients (4.6%), of which 3 (2.8%) were symptomatic and 2 (1.8%) asymptomatic on routine postoperative ultrasound. DVT occurrence was significantly associated with factors including motor impairment, neurological deficits, duration of preoperative hospitalization, intraoperative blood loss, and the need for transfusion. Additional factors such as level of consciousness, severity of pain, time to postoperative mobilization, duration of surgery, age, underlying medical conditions, surgical history and cause, number of spinal fusion levels, and BMI also showed significant associations with DVT. No significant correlation was found with gender or preoperative anticoagulant use.

CONCLUSION

Identifying risk factors for DVT in patients undergoing lumbosacral PSF can help inform targeted preventive strategies and improve patient outcomes. These findings underscore the importance of early mobilization, careful perioperative management, and individualized risk assessment in spinal surgery patients.