2024-03-29T09:38:42Zhttps://eprints.lib.hokudai.ac.jp/dspace-oai/requestoai:eprints.lib.hokudai.ac.jp:2115/738042022-11-17T02:08:08Zhdl_2115_20040hdl_2115_121Rapidly progressive cervical myelopathy had a high risk of developing deep venous thrombosis : a prospective observational study in 289 cases with degenerative cervical spine diseaseDVT in degenerative cervical spine diseaseYamada, KatsuhisaSuda, KotaMatsumoto Harmon, SatokoKomatsu, MikiUshiku, ChikaraTakahata, MasahikoMinami, AkioIwasaki, Norimasa490Study design: A prospective observational study. Objectives: To determine the incidence of deep venous thrombosis (DVT) and to evaluate the risk factors for DVT development associated with degenerative cervical spine disease. Setting: Hokkaido Spinal Cord Injury Center, Japan. Methods: Between April 2008 and March 2015, patients with degenerative cervical spine disease, such as compressive myelopathy or radiculopathy, who underwent surgical treatment were prospectively assessed. Leg vein ultrasonography and D-dimer tests were performed preoperatively and at 4 days after surgery. All patients received treatment with intermittent pneumatic compression and elastic stockings for primary DVT prophylaxis. No anticoagulation medications were used for DVT prophylaxis. Results: A total of 289 patients (203 males, 86 females; median age: 67 years (interquartile range, 58-76)) were included. Nine patients (3.1%) exhibited DVT during the perioperative period. All 9 cases were women who had distal DVT. The incidences of preoperative and postoperative DVT were 1.1% and 2.1%, respectively. The univariate analysis showed that statistically significant risk factors for perioperative DVT included female gender (P < 0.01), advanced age (P = 0.04), a low Japanese Orthopaedic Association score (P = 0.03), rapidly progressive myelopathy (P < 0.01), and inability to walk (P = 0.01). The multivariate analysis showed that rapidly progressive myelopathy (P = 0.04) was the most important risk factor. Conclusion: Female gender and rapidly progressive myelopathy are high-risk factors that predict the development of DVT during the perioperative period of cervical spine surgery. This result indicates that screening and treatment for DVT are needed in such high-risk patients.Nature researchJournal Articleapplication/pdfhttp://hdl.handle.net/2115/73804https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/73804/1/Spinal_cord_57_58.pdf1362-4393Spinal cord57158642019-01enginfo:doi/10.1038/s41393-018-0213-9author