Work

Increased Risk of Venous Thromboembolism Following Posterior Versus Anterior Cervical Spine Fusion: A Propensity-Matched Cohort Study

Year: 2025

Type: article

Abstract: Study Design Propensity-matched retrospective cohort study. Objective This study aimed to compare the incidence of venous thromboembolism (VTE) complications following posterior cervical decompression and fusion (PCDF) and anterior cervical discectomy and fusion (ACDF). Methods The TriNetX database was queried for patients >18 years old undergoing single- or multi-level ACDF or PCDF between 2004 and 2024. Patients with prior VTE, thrombophilia, or prior cervical spine surgery were excluded. Propensity score matching was performed using demographics, comorbidities, and anticoagulation use. Primary outcomes included 30- and 90-day incidence of VTE events and post-operative bleeding complications. Differences between PCDF and ACDF were reported as odds ratios with 95% confidence intervals (CI). Results There were 4381 patients included in each single-level cohort and 15 577 patients in each multi-level cohort. Compared to single-level ACDF, single-level PCDF was associated with higher odds of VTE events at 30-days (OR: 1.96, 95% CI: 1.28-2.94; P = 0.001) and 90-days (OR: 2.05, 95% CI: 1.43-2.94; P < 0.001). Multi-level PCDF was also associated with higher odds of VTE events at 30-days (OR: 3.83, 95% CI: 3.13-4.76; P < 0.001) and 90-days (OR: 3.97, 95% CI: 3.33-4.76; P < 0.001) when compared to multi-level ACDF. There were no significant differences in post-operative bleeding complications ( P > 0.05). Conclusions PCDF was associated with increased VTE complications with no differences in postoperative bleeding events when compared to ACDF. Incorporating surgical approach may enhance VTE risk assessment following cervical spine surgery.

Source: Global Spine Journal

DOI: 10.1177/21925682251405779

Authors: Jason Silvestre, Robert J. Ferdon, James P. Lawrence, Charles A. Reitman, Robert A. Ravinsky

Institution: Medical University of South Carolina

Language: English

Topic: Cervical and Thoracic Myelopathy

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,650