EFFICACY OF EARLY LOW-MOLECULAR-WEIGHT HEPARIN PROPHYLAXIS IN ELDERLY PATIENTS AFTER DEGENERATIVE SPINAL SURGERY: A BRIEF RETROSPECTIVE REVIEW.

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Gianfilippo Caggiari, Emanuele Ciurlia, Sebastiano Ortu, Andrea Donato, Francesco Pisanu, Carlo Doria

Many orthopaedic surgical procedures are potentially affected by deep vein thrombosis (DVT) and Pulmonary Embolism (PE). DVT and PE are a clinical expression of the same pathological process called venous thromboembolism (VTE). Low-molecular-weight heparin (LMWH) is approved/ recognized to be a pharmacological solution to prevent VTE. The objective of the current study is twofold: (i) to assess the effect of a therapeutic protocol with LWMH started 24 hours after surgery on systemic bleeding and ii) to assess its effect on thrombosis and pulmonary embolism risk in patients undergoing early prophylaxis after spine surgery. A consecutive cohort of 110 patients undergoing spinal surgery was tested. Fifty six cases were spinal stenosis and 54 were degenerative thoracolumbar kypho-scoliosis. None of the patients withdrew from the study. 2 patients manifested PE signs and a prophylactic protocol therapy with LMWH which was started 24 hours after spine surgery resulted in a very low haemorrhage risk and low rate of PE and DVT.

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