Electronic file material, ArticlePlus



Electronic file material, ArticlePlus

Table 1. Demographic data of included studies.

|Author |Study |Population |Condition and Treatment |Prophylaxis |

|(Year) |Design | | | |

|Boakye |Retrospective |N = 58,115 |Cervical spondylotic myelopathy |NR |

|(2008) |cohort |Mean age: 51% were 45-64 |Spinal fusion surgery | |

| |National Inpatient |yrs | | |

| |Sample database |42% male | | |

|Otero-Ferna|Prospective cohort |N = 225 |Various spine conditions |Daily bemiparin (LMWH) 2500 IU |

|ndez | |Mean age: NR for spine |“Spine surgery” |(moderate risk) or 3500 IU (high risk)|

|(2008) | |surgery* | | |

| | |NR% male | | |

|Piasecki |Prospective |N = 66 |Scoliosis (n = 40) or revision surgery (n = 26) after failed |Mechanical prophylaxis with foot pumps|

|(2008) |cohort |Mean age: 52 yrs |fusion or laminectomy |during and post-op |

| | |14% male |Combined anterior/posterior fusion spine surgery; | |

|Schizas |Prospective |N = 270 |Spinal stenosis (n = 77), fractures or posttraumatic |IPCs and enoxoparin (LMWH), 20mg daily|

|(2008) |cohort |Mean age: 44 yrs |deformities (n = 57), DDD (n = 37), herniated discs (n = 26), |for 3 days postop, then 40mg daily |

| | |NR% male |spondylolisthesis (n = 27), scoliosis (n = 23), tumors (n = |until discharge |

| | | |8), infections (n = 8), rheumatoid arthritis (n = 7) | |

| | | |Anterior and/or posterior spinal fusions, discectomies and/or | |

| | | |decompression surgeries | |

|Chin (2007)|Prospective and |N = 89 |Lumbar disc disease |30 mg ketorolac (Toradol) immediately |

| |retrospective |Median age: |Lumbar microdiscectomy |before wound closure (n = 44) or none|

| |cohort |cases 36 yrs | |(n = 45) |

| | |controls 47 yrs | | |

| | |54% male | | |

|Patel |Retrospective |N = 84 |Degenerative disease |NR |

|(2007) |cohort |Mean age: 59 yrs |Elective lumbar and thoracic spinal fusion | |

| | |35% male | | |

|Epstein |Retrospective |N = 139 |Stenosis with instability, spondylolisthesis |IPCs used for prophylaxis |

|(2006) |cohort |Mean age: 53 yrs |Multilevel lumbar laminectomies with instrumented fusion | |

| | |56% male | | |

|Awad (2005)|Retrospective |N = 134 |Various spine conditions |NR |

| |case-control |Mean age: |All levels of spinal surgery. | |

| | |cases 60 yrs |(Cases (n = 32) developed post-operative spinal epidural | |

| | |controls 55 yrs |hematoma, controls were matched by complexity of spinal | |

| | |52% male |surgery procedure and time period.) | |

|Epstein |Retrospective |Single-level, N = 100 |Spondylosis, stenosis, and/or OPLL |Intermittent compression stockings |

|(2005) |cohort |Mean age: 46 yrs |Single-level anterior corpectomy/fusion (ACF) (n = 100) and |(IPCs) |

| | |57% male |multilevel ACF/posterior fusion (n = 100) | |

| | |Multilevel, N = 100 | | |

| | |Mean age: 55 yrs | | |

| | |65% male | | |

|Brau (2004)|Retrospective |N = 1310 |Lumbar disc disease |NR |

| |cohort |Age range: 18-84 yrs |ALIF or total disc replacement using mini-open, | |

| | |49% male |retroperitoneal approach | |

|Gerlach |Retrospective |N = 1954 |Spinal stenosis or disc herniation (n = 1618), stabilization |Received intra- and post-operative |

|(2004) |cohort |Mean age: NR |(n = 55), tumor (n = 182), infection (n = 57), fractures (n = |IPCs AND postop daily 0.3ml nadroparin|

| | |NR% male |28), hematoma (n = 14) |calcium, 2850 IU anti-Xa |

| | | |Cervical, thoracic and lumbar spinal procedures | |

|Scaduto |Prospective cohort |N = 119 |Lumbar disc disease | |

|(2003) | |Mean age: 44 yrs |ALIF (n = 88) or PLF (n = 31) | |

| | |44% male | | |

|Brau (2002)|Retrospective |N = 686 |Lumbar disc disease |NR |

| |cohort |Age range: 19-84 yrs |ALIF using mini-open, retroperitoneal approach | |

| | |50.3% male | | |

|Lee (2000)|Retrospective |N = 313 |Stenosis (n = 101), spondylolisthesis (n = 68), herniated disc|No antithrombotic prophylaxis |

| |cohort |Mean age: 48 yrs |(n = 8), scoliosis (n = 13), OPLL (n = 2), CSM (n = 25), | |

| | |49% male |infection (n = 26), fracture (n = 62), tumor (n = 8) | |

| | | |Multilevel anterior and/or posterior decompression and/or | |

| | | |fusions | |

|Oda (2000) |Retrospective |N = 110 |Stenosis (n = 20), scoliosis (n = 8), arthrodesis (n = 10), |No mechanical or medical |

| |cohort |Mean age: 59 yrs |herniated disc (n = 24), scoliosis, OPLL (n = 11), myelopathy |antithrombotic prophylaxis |

| | |58% male |(n = 34), tumor (n = 3) | |

| | | |Posterior spinal surgery. | |

|Dearborn |Prospective and |Prospective, N = 116 |Scoliosis, stenosis, spondylolisthesis, kyphosis, |Thigh-length elastic antiembolism |

|(1999) |retrospective |Mean age: 46 yrs |pseudoarthrosis, or other degenerative spinal conditions |stockings and IPCs during and postop; |

| |cohort |29% male |Anterior, posterior or combined ant/post spinal reconstruction|no pharmacologic anticoagulation |

| | |Retrospective, N = 267 |surgery | |

| | |Mean age: 48 yrs | | |

| | |28% male | | |

|Rajaraman |Prospective cohort |N = 60 |Discogenic back pain (n = 33), failed back syndrome (n = 11), |NR |

|(1999) | |Mean age: 42 yrs |pseudoarthrosis, (n = 5) postlaminectomy syndrome (n = 4), | |

| | |52% male |spondylolisthesis (n = 3), fracture (n = 2), tumor (n = 2) | |

| | | |ALIF via retroperitoneal (n = 57) or transperitoneal (n = 3) | |

|Rokito |Prospective cohort |N = 110 |lumbar disorder (n = 86), scoliosis (n = 14), thoracic |Thigh-high compression stockings (n = |

|(1996) | |Mean age: 44 yrs |disorder (n = 7), cervical disorder (n = 1), trauma (n = 2) |42), compression stockings and |

| | |40% male |Anterior and/or posterior spinal fusions and/or decompression |thigh-length IPCs (n = 33), or |

| | | |surgery |compression stockings and 10mg |

| | | | |Coumadin on the evening before surgery|

| | | | |and daily postop (n = 35) |

|Smith |Prospective cohort |N = 317 |Degenerative spine disease (n = 172), spondylolisthesis (n = | Thigh-length IPCs, no medical |

|(1994) | |Mean age: NR |31) spinal trauma (n = 34), scoliosis (n = 77), infection (n =|antithrombotic prophylaxis |

| | |NR% male |3) | |

| | | |Spinal surgery | |

|Ferreea |Prospective cohort |N = 86 |Scoliosis, degenerative disc disease, spondylolisthesis, |IPCs |

|(1993) | |Mean age: 43 yrs |instability | |

| | |53% male |Lumbar (n = 78) or thoracic (n = 8) decompression and/or | |

| | | |fusion spine | |

|West (1992)|Prospective cohort|N = 41 |Spinal deformity (n = 14), trauma (n = 16), degenerative spine|No preoperative or intraoperative |

| | |Mean age: 38 yrs |disease (n = 11) |thrombotic prophylaxis; used postop |

| | |NR% male |Anterior and/or posterior instrumented fusion |compression stockings |

|Ramirez |Prospective cohort |N = 35,708 |Lumbar disc displacement or degeneration, no history of |NR |

|(1989) | |Mean age: NR |previous surgery; | |

| | |NR% male |Lumbar discectomy at one or two levels without fusion | |

| | |Commission on Professional | | |

| | |and Hospital Activities | | |

| | |Database | | |

|Uden (1979)|Prospective cohort |N = 1229 |Scoliosis |NR |

| | |Mean age: 57 yrs |Fusion using Harrington rods | |

| | |33% male | | |

|Gruber |Prospective cohort |N = 50 |Herniated lumbar disc |2500 IU miniheparin-dihydroergotamine |

|(1984) | |Heparin |(treatments) |two times daily (n = 25) or placebo (n|

| | |Mean age: 47 yrs | |= 20), beginning 2 hrs preoperatively |

| | |57% male | |and continuing at least 7 days or |

| | |Placebo | |until hospital discharge |

| | |Mean age: 45 yrs | | |

| | |65% male | | |

|Voth (1992)|Prospective cohort |N = 179 |(conditions) |1500 U-aPTT LMWH plus |

| | |LMWH |Lumbar-vertebral disc procedures |dihydroergotamine 0.5 mg once daily |

| | |Mean age: 53 yrs |Fenestration (n = 166) |plus placebo injection daily (n = 87) |

| | |44% male |Hemilaminectomy (n = 7) |or 5000 U heparin plus |

| | |HDHE |Laminectomy (n = 3) |dihydroergotamine 0.5 mg twice a day |

| | |Mean age: 53 yrs |Sequestrotomy (n = 1) |(n = 92), beginning 2 hrs |

| | |45% male |NR (n = 2) |preoperatively and continued for at |

| | | | |least 7 days |

|Fereeb |Prospective cohort |N = 185 |Laminectomy or laminotomy (n = 84); posterior spinal fusion |Elastic compression stockings (n = 74)|

|(1993) | |Elastic compression: |with or without laminectomy or laminotomy (n = 101) |or intermittent pneumatic compression |

| | |Mean age: 43 yrs | |(n = 111) |

| | |NR% male | | |

| | |Pneumatic compression: | | |

| | |Mean age: 50 yrs | | |

| | |NR% male | | |

|Flinn |Prospective cohort |N = 2643 |Craniotomies for treatment of neoplasms or cerebrovascular |Elastic stockings and IPC |

|(1996) | |Mean age: 58 yrs |disorders (n = 1439); ventriculoperitoneal or other shunting | |

| | |52% male |procedures (n = 299); cervical or lumbar spinal surgeries (n =| |

| | | |454) | |

|Wood |Prospective cohort |N = 136 |Major reconstructive spinal surgeries defined as anterior |Thigh-high pneumatic compression wraps|

|(1997) | |Plexi Pulse: |and/or posterior thoracic, lumbar, or thoracolumbar spinal |or pneumatic foot-compression wraps |

| | |Mean age: 39 yrs |fusions and/or multilevel decompression surgery | |

| | |52% male | | |

| | |SCD: | | |

| | |Mean age: 40 yrs | | |

| | |66% male | | |

|Nelson |Prospective cohort |N = 117 |Degenerative spinal disease; posterior lumbar decompression |TED stockings and acetylsalicyclic |

|(1996) | |Mean age: NR |with fusion and fixation |acid (ASA) 600 mg bid (n = 60) or TED |

| | |NR% male | |and pneumatic compression boots and |

| | | | |ASA 600 mg bid (n = 57) |

ALIF = anterior lumbar interbody fusion ; CSM = cervical spondylotic myelopathy; DDD = degenerative disc disease; DVT = deep vein thrombosis; INR = International Normalized Ratio; IPCs = intermittent compression stockings; LMWH = low-molecular weight heparin; NR = not reported; OPLL = ossification of the posterior longitudinal ligament; PE = pulmonary embolism.

*Study included orthopedic surgery patients; data reported for spine surgery only.

Table 2. Frequencies of thromboembolism by spine condition in patients whose chemical antithrombotic prophylaxis was not reported.

|Spine Condition treated | |DVT |PE |Fatal PE |

| |Author |n/N (%) |n/N (%) |n/N (%) |

|Degenerative |Boakye (2008)8 |--------- |407/58115 (0.7) |--------- |

| |Patel (2007)10 |2/84 (2.4) |--------- |--------- |

| |Brau (2002)9 |7/686 (1.0) |0/686 (0.0) |--------- |

| |Ramirez (1989)7 |--------- |38/35708 (0.11) |4/35708 (0.01) |

| |Scaduto (2003) |2/88 (2.3) |--------- |--------- |

|Deformity |Uden (1979)6 |8/1229 (0.65) |1/1229 (0.08) |1/1229 (0.08) |

|Multiple spine conditions |Rajaraman (1999)4 |1/60 (1.7) |--------- |--------- |

Table 3. Level of Evidence grade for studies reporting rate of thromboembolic events in spine surgery.

|Methodological Principle |Boakye 2008|Brau |Dearborn 1999 |Epstein |Epstein |Ferreea |Ferreeb |

| | |2002 | |2005 |2006 |1993 |1993 |

|Prospective cohort study |( | |( |( |( |( |( |

|Retrospective cohort study | |( | | | | | |

|Case Control | | | | | | | |

|Patients at similar point in the course of their disease or | ( |(  |(  | ( | ( |( |( |

|treatment | | | | | | | |

|Patients followed long enough for outcomes to occur | ( | ( | ( |( | ( |( |( |

|Complete follow-up of >80% |( | ( | ( | ( | ( |( |( |

|Controlling for extraneous prognostic factors |  |  | | | | | |

|Evidence |II |II |III |II |

|Level | | | | |

|Boakye |Retrospective |N = 58,115 |Cervical spondylotic myelopathy |NR |

|(2008) |cohort |Mean age: 51% were 45-64 |Spinal fusion surgery | |

| |National Inpatient |yrs | | |

| |Sample database |42% male | | |

|Otero-Ferna|Prospective cohort |N = 225 |Various spine conditions |Daily bemiparin (LMWH) 2500 IU |

|ndez | |Mean age: NR for spine |“Spine surgery” |(moderate risk) or 3500 IU (high risk)|

|(2008) | |surgery* | | |

| | |NR% male | | |

|Piasecki |Prospective |N = 66 |Scoliosis (n = 40) or revision surgery (n = 26) after failed |Mechanical prophylaxis with foot pumps|

|(2008) |cohort |Mean age: 52 yrs |fusion or laminectomy |during and post-op |

| | |14% male |Combined anterior/posterior fusion spine surgery; | |

|Schizas |Prospective |N = 270 |Spinal stenosis (n = 77), fractures or posttraumatic |IPCs and enoxoparin (LMWH), 20mg daily|

|(2008) |cohort |Mean age: 44 yrs |deformities (n = 57), DDD (n = 37), herniated discs (n = 26), |for 3 days postop, then 40mg daily |

| | |NR% male |spondylolisthesis (n = 27), scoliosis (n = 23), tumors (n = |until discharge |

| | | |8), infections (n = 8), rheumatoid arthritis (n = 7) | |

| | | |Anterior and/or posterior spinal fusions, discectomies and/or | |

| | | |decompression surgeries | |

|Chin (2007)|Prospective and |N = 89 |Lumbar disc disease |30 mg ketorolac (Toradol) immediately |

| |retrospective |Median age: |Lumbar microdiscectomy |before wound closure (n = 44) or none|

| |cohort |cases 36 yrs | |(n = 45) |

| | |controls 47 yrs | | |

| | |54% male | | |

|Patel |Retrospective |N = 84 |Degenerative disease |NR |

|(2007) |cohort |Mean age: 59 yrs |Elective lumbar and thoracic spinal fusion | |

| | |35% male | | |

|Epstein |Retrospective |N = 139 |Stenosis with instability, spondylolisthesis |IPCs used for prophylaxis |

|(2006) |cohort |Mean age: 53 yrs |Multilevel lumbar laminectomies with instrumented fusion | |

| | |56% male | | |

|Awad (2005)|Retrospective |N = 134 |Various spine conditions |NR |

| |case-control |Mean age: |All levels of spinal surgery. | |

| | |cases 60 yrs |(Cases (n = 32) developed post-operative spinal epidural | |

| | |controls 55 yrs |hematoma, controls were matched by complexity of spinal | |

| | |52% male |surgery procedure and time period.) | |

|Epstein |Retrospective |Single-level, N = 100 |Spondylosis, stenosis, and/or OPLL |Intermittent compression stockings |

|(2005) |cohort |Mean age: 46 yrs |Single-level anterior corpectomy/fusion (ACF) (n = 100) and |(IPCs) |

| | |57% male |multilevel ACF/posterior fusion (n = 100) | |

| | |Multilevel, N = 100 | | |

| | |Mean age: 55 yrs | | |

| | |65% male | | |

|Brau (2004)|Retrospective |N = 1310 |Lumbar disc disease |NR |

| |cohort |Age range: 18-84 yrs |ALIF or total disc replacement using mini-open, | |

| | |49% male |retroperitoneal approach | |

|Gerlach |Retrospective |N = 1954 |Spinal stenosis or disc herniation (n = 1618), stabilization |Received intra- and post-operative |

|(2004) |cohort |Mean age: NR |(n = 55), tumor (n = 182), infection (n = 57), fractures (n = |IPCs AND postop daily 0.3ml nadroparin|

| | |NR% male |28), hematoma (n = 14) |calcium, 2850 IU anti-Xa |

| | | |Cervical, thoracic and lumbar spinal procedures | |

|Scaduto |Prospective cohort |N = 119 |Lumbar disc disease | |

|(2003) | |Mean age: 44 yrs |ALIF (n = 88) or PLF (n = 31) | |

| | |44% male | | |

|Brau (2002)|Retrospective |N = 686 |Lumbar disc disease |NR |

| |cohort |Age range: 19-84 yrs |ALIF using mini-open, retroperitoneal approach | |

| | |50.3% male | | |

|Lee (2000)|Retrospective |N = 313 |Stenosis (n = 101), spondylolisthesis (n = 68), herniated disc|No antithrombotic prophylaxis |

| |cohort |Mean age: 48 yrs |(n = 8), scoliosis (n = 13), OPLL (n = 2), CSM (n = 25), | |

| | |49% male |infection (n = 26), fracture (n = 62), tumor (n = 8) | |

| | | |Multilevel anterior and/or posterior decompression and/or | |

| | | |fusions | |

|Oda (2000) |Retrospective |N = 110 |Stenosis (n = 20), scoliosis (n = 8), arthrodesis (n = 10), |No mechanical or medical |

| |cohort |Mean age: 59 yrs |herniated disc (n = 24), scoliosis, OPLL (n = 11), myelopathy |antithrombotic prophylaxis |

| | |58% male |(n = 34), tumor (n = 3) | |

| | | |Posterior spinal surgery. | |

|Dearborn |Prospective and |Prospective, N = 116 |Scoliosis, stenosis, spondylolisthesis, kyphosis, |Thigh-length elastic antiembolism |

|(1999) |retrospective |Mean age: 46 yrs |pseudoarthrosis, or other degenerative spinal conditions |stockings and IPCs during and postop; |

| |cohort |29% male |Anterior, posterior or combined ant/post spinal reconstruction|no pharmacologic anticoagulation |

| | |Retrospective, N = 267 |surgery | |

| | |Mean age: 48 yrs | | |

| | |28% male | | |

|Rajaraman |Prospective cohort |N = 60 |Discogenic back pain (n = 33), failed back syndrome (n = 11), |NR |

|(1999) | |Mean age: 42 yrs |pseudoarthrosis, (n = 5) postlaminectomy syndrome (n = 4), | |

| | |52% male |spondylolisthesis (n = 3), fracture (n = 2), tumor (n = 2) | |

| | | |ALIF via retroperitoneal (n = 57) or transperitoneal (n = 3) | |

|Rokito |Prospective cohort |N = 110 |lumbar disorder (n = 86), scoliosis (n = 14), thoracic |Thigh-high compression stockings (n = |

|(1996) | |Mean age: 44 yrs |disorder (n = 7), cervical disorder (n = 1), trauma (n = 2) |42), compression stockings and |

| | |40% male |Anterior and/or posterior spinal fusions and/or decompression |thigh-length IPCs (n = 33), or |

| | | |surgery |compression stockings and 10mg |

| | | | |Coumadin on the evening before surgery|

| | | | |and daily postop (n = 35) |

|Smith |Prospective cohort |N = 317 |Degenerative spine disease (n = 172), spondylolisthesis (n = | Thigh-length IPCs, no medical |

|(1994) | |Mean age: NR |31) spinal trauma (n = 34), scoliosis (n = 77), infection (n =|antithrombotic prophylaxis |

| | |NR% male |3) | |

| | | |Spinal surgery | |

|Ferreeb |Prospective cohort |N = 86 |Scoliosis, degenerative disc disease, spondylolisthesis, |IPCs |

|(1993) | |Mean age: 43 yrs |instability | |

| | |53% male |Lumbar (n = 78) or thoracic (n = 8) decompression and/or | |

| | | |fusion spine | |

|West (1992)|Prospective cohort|N = 41 |Spinal deformity (n = 14), trauma (n = 16), degenerative spine|No preoperative or intraoperative |

| | |Mean age: 38 yrs |disease (n = 11) |thrombotic prophylaxis; used postop |

| | |NR% male |Anterior and/or posterior instrumented fusion |compression stockings |

|Ramirez |Prospective cohort |N = 35,708 |Lumbar disc displacement or degeneration, no history of |NR |

|(1989) | |Mean age: NR |previous surgery; | |

| | |NR% male |Lumbar discectomy at one or two levels without fusion | |

| | |Commission on Professional | | |

| | |and Hospital Activities | | |

| | |Database | | |

|Uden (1979)|Prospective cohort |N = 1229 |Scoliosis |NR |

| | |Mean age: 57 yrs |Fusion using Harrington rods | |

| | |33% male | | |

|Gruber |Prospective cohort |N = 50 |Herniated lumbar disc |2500 IU miniheparin-dihydroergotamine |

|(1984) | |Heparin |(treatments) |two times daily (n = 25) or placebo (n|

| | |Mean age: 47 yrs | |= 20), beginning 2 hrs preoperatively |

| | |57% male | |and continuing at least 7 days or |

| | |Placebo | |until hospital discharge |

| | |Mean age: 45 yrs | | |

| | |65% male | | |

|Voth (1992)|Prospective cohort |N = 179 |(conditions) |1500 U-aPTT LMWH plus |

| | |LMWH |Lumbar-vertebral disc procedures |dihydroergotamine 0.5 mg once daily |

| | |Mean age: 53 yrs |Fenestration (n = 166) |plus placebo injection daily (n = 87) |

| | |44% male |Hemilaminectomy (n = 7) |or 5000 U heparin plus |

| | |HDHE |Laminectomy (n = 3) |dihydroergotamine 0.5 mg twice a day |

| | |Mean age: 53 yrs |Sequestrotomy (n = 1) |(n = 92), beginning 2 hrs |

| | |45% male |NR (n = 2) |preoperatively and continued for at |

| | | | |least 7 days |

|Fereea |Prospective cohort |N = 185 |Laminectomy or laminotomy (n = 84); posterior spinal fusion |Elastic compression stockings (n = 74)|

|(1993) | |Elastic compression: |with or without laminectomy or laminotomy (n = 101) |or intermittent pneumatic compression |

| | |Mean age: 43 yrs | |(n = 111) |

| | |NR% male | | |

| | |Pneumatic compression: | | |

| | |Mean age: 50 yrs | | |

| | |NR% male | | |

|Flinn |Prospective cohort |N = 2643 |Craniotomies for treatment of neoplasms or cerebrovascular |Elastic stockings and IPC |

|(1996) | |Mean age: 58 yrs |disorders (n = 1439); ventriculoperitoneal or other shunting | |

| | |52% male |procedures (n = 299); cervical or lumbar spinal surgeries (n =| |

| | | |454) | |

|Wood |Prospective cohort |N = 136 |Major reconstructive spinal surgeries defined as anterior |Thigh-high pneumatic compression wraps|

|(1997) | |Plexi Pulse: |and/or posterior thoracic, lumbar, or thoracolumbar spinal |or pneumatic foot-compression wraps |

| | |Mean age: 39 yrs |fusions and/or multilevel decompression surgery | |

| | |52% male | | |

| | |SCD: | | |

| | |Mean age: 40 yrs | | |

| | |66% male | | |

|Nelson |Prospective cohort |N = 117 |Degenerative spinal disease; posterior lumbar decompression |TED stockings and acetylsalicyclic |

|(1996) | |Mean age: NR |with fusion and fixation |acid (ASA) 600 mg bid (n = 60) or TED |

| | |NR% male | |and pneumatic compression boots and |

| | | | |ASA 600 mg bid (n = 57) |

DVT = Deep vein thrombosis; PE = Pulmonary embolism

NR = no report

INR = International Normalized Ratio

Ossification of the posterior longitudinal ligament (OPLL)

CSM = cervical spondylotic myelopathy

LMWH = low-molecular weight heparin

DDD = degenerative disc disease

Intermittent compression stockings (IPCs)

Anterior lumbar interbody fusion (ALIF)

*Study included orthopedic surgery patients; data reported for spine surgery only

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