Hideaki Watanabe1*, Hirokazu Inoue2, Akira Murayama2, Shinya Hayasaka3, Ichiro Kikkawa1 and Katsushi Takeshita2
1Department of Pediatric Orthopedic Surgery, Jichi Children’s Medical Center, Japan
2Department of Orthopedic Surgery, Jichi Medical University, Japan
3Department of Human Life Sciences, Tokyo City University, Japan
Aim: To investigate changes in blood coagulation and fibrinolysis markers before and after spinal surgery in adolescent and older patients and to explore possible reasons for the development of postoperative venous thromboembolism (VTE).Methods: This retrospective two-center study enrolled 57 low-risk patients who underwent spinal surgery at either our children’s institution or our public hospital between October 2012 and April 2015. Altogether, 27 adolescent idiopathic scoliosis (AIS) patients (3 boys, 24 girls; mean age 15 years, range 11–19 years) underwent instrumentation for posterior fusion. Also, 30 lumbar spinal canal stenosis (LSCS) patients (16 men, 15 women; mean age 71 years, range 52–88 years) underwent laminectomy for posterior decompression. Plasma levels of soluble fibrin monomer complex (SFMC), D-dimer, and plasminogen activator inhibitor type 1 (PAI-1) were measured 1 day preoperatively and on postoperative days (PODs) 1, 3, and 7.Results: No patients in this study developed symptomatic or asymptomatic VTE postoperatively. The SFMC level showed significant increases on PODs 1 and 3 in the AIS patients and on POD 1 in the LSCS patients. The D-dimer level showed significant increases on PODs 1, 3, and 7 in both groups. The PAI-1 levels showed significant increases on POD 7 in the AIS patients and on PODs 1, 3, and 7 in the LSCS patients.Conclusion: The significantly higher postoperative PAI-1 levels in older patients could be associated with the development and progression of symptomatic VTE.
Venous thromboembolism; Adolescent idiopathic scoliosis; Spinal surgery; Blood coagulation-fibrinolysis marker; D-dimer; Soluble fibrin monomer complex; Plasminogen activator inhibitor type 1
Watanabe H, Inoue H, Murayama A, Hayasaka S, Kikkawa I, Takeshita K. Changes in Blood Coagulation and Fibrinolysis Markers Before and After Spinal Surgery in Adolescent and Older Patients. Clin Surg. 2016; 1: 1255.