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Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE) Prophylaxis in Spinal Neurosurgery; Dr. Nancy Epstein

Dr. Epstein discusses the evidence for the diagnosis and. treatment of Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE) , which is commonly seen in all branches of Medicine and by Spine Surgeons. She reviews the studies indicating the value in early recognition of this problem to prevent the serious complications that follow this disease. The value in Elastic Stockings, Mechanical Compression Stockings, which combined with chemoprophylaxis (with Low Dose Heparin or Low Molecular Weight Heparin or equivalents)  will significantly lower the risks associated with DVTs to under 1% and eliminate PEs. The risks of bleeding with chemoprophylaxis is similar to that without their use.  The use of postoperative ultrasound to detect the disease is helpful if available. Early ambulation is the simplist and safest preventative measure to use. The value of Intravenous filters (IVF) for recurrent PEs and the timing of their removal are discussed.  Other surgical problems as CSF leak are addressed to obtain a tight dural closure and will allow early ambulation. Dealing with other challenging issues are also discussed.  The doctor checking the patient 48 hours after surgery is a time-investment that will diminish the late appearance of DVT. A high index of suspicion preoperatively is also very helpful. An excellent Review for those in all branches of Medicine and Surgery.

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Moderator / Speaker
  • James I. Ausman, MD, MA, PhD

    CEO SNI and SNI Digital; Emeritus Professor Neurosurgery

James I. and Carolyn R. Educational Foundation

  • Nancy Epstein, MD

    Chief, Neurosurgical Spine and Education, Winthrop Univesrit...

Neurosurgeon, Spine Neurosurgery, Professor of Clinical Neurosurgery, School of Medicine, State Univ...

Panelists