Abstract
We reviewed 24 cases (13 men and 11 women, mean age 69.1 years, mean height 157 cm, mean weight 57.1 kg) to investigate the rate of pulmonary embolism after spinal fusion with pedicle screws.
All of the patients completed inhalation therapy for the prevention of pulmonary embolism before the operation. Their legs were compressed by an intermittent pressure flow pump during the operation. They also wore elastic stockings before and after the operation until they discharged from hospital. We measured SpO2 when supplemental oxygen inhalation was stopped the day after operation. The patients were allowed to walk from the third to fifth post-operative day. Clinical signs were checked during the first five post-operative days. D-dimmer levels and blood gas levels were examined during the sixth to eighth post-operative days. Between the seventh to nineth post-operative days, all patients were examined for pulmonary embolism by lung scintigraphy. The pulmonary embolisms were classified into four groups (large, middle, small, and mosaic defect).
Pulomnary embolism was diagnosed in 12 patients (50%) (4 middle defects,4 small defects, 4 mosaic defects). Four patients in the non-pulmonary embolism group had clinical signs. Ten patients in the pulmonary embolism group had clinical signs, and 7 patients had fever higher than 38.5°C. There were no significant differences in age, sex, BMI, operation time, bleeding amount, arterial blood gas levels, SpO2 or D-dimmer levels between the 2 groups.
The rate of the pulmonary embolism after the spinal fusion with pedicle screws was higher than we had expected.
