VIENNA – With few thrombotic events being reported in the literature following spine surgery, Austrian investigators found some benefits to postoperative administration of a low-molecular-weight-heparin subcutaneously the night after spine surgery and up to 4 weeks afterward in their prospective 150-patient controlled cohort study.
During the 2010 Annual Congress of the Spine Society of Europe (EuroSpine 2010), held here, Michael P. Matzner, MD, of Vienna, presented the results on behalf of the investigators, Josef G. Grohs, MD, and colleagues, in the orthopedic department at the Medical University Vienna.
Matzner told ORTHOSuperSite.com that using Bemiparin (bemiparin sodium) in standard surgeries performed at typical levels is now a common practice among members of the department where the study was conducted.
“Bemiparin postoperative thromboprophylaxis shows no increasing of thromboembolic events,” he said in the presentation.
Study design
According to Matzner, the impetus for conducting the study was the lack of sufficient data on the comparative effectiveness and safety of pre- vs. postoperative administered thromboprophylaxis.
The study involved 241 patients who underwent surgery that involved opening up the spinal area; 150 patients received their first 3,500 IU/day dose of bemiparin sodium, a low-molecular-weight heparin, on the evening after surgery and 91 patients received the same dose of the drug the day before surgery and served as the control group.
Fatal thromboembolism was the study’s primary endpoint. Secondary endpoints included major bleeding and delayed wound healing.
Complications analyzed
In the control or preoperatively prophylaxed group investigators found a 0.11 incidence risk of fatal thromboprophylaxis vs. a 0.01 risk for the group with postoperative treatment, Matzner said.
Although rates of complications were not statistically different in the study, “The drug had the potential of reduction of complication incidence of almost 50%,” and surgeons noticed a slight epidural bleeding reduction with its use, he said.
Reference:Lunzer A, Vavken P, Grohs JG. Postoperative antithrombotic therapy after spine operations – negligent or safe and effective? Special Poster Presentation #60. Presented at EuroSpine 2010. Sept. 15-17, 2010. Vienna.