Difference in the changings of blood coagulation fibrinolysis markers before and after spinal surgery in adolescent and elderly patients

Hideaki Watanabe, Hirokazu Inoue, Yasuyuki Shiraishi, Ryo Sugawara, Shinya Hayasaka, Ichiro Kikkawa, Katsushi Takeshita

Abstract


AIM: The purpose of this study is to investigate the differences in changing of blood coagulation and fibrinolysis markers before and after spinal surgery in adolescent and elderly patients.

MATERIALS AND METHODS: This retrospective two-center study enrolled 56 low-risk patients between October 2012 and April 2015. 27 adolescent idiopathic scoliosis (AIS) patients (3 boys, 24 girls; mean age 15 years) underwent instrumentation for posterior fusion. 29 lumbar spinal canal stenosis (LSCS) patients (15 men, 14 women; mean age 71 years) underwent laminectomy for posterior decompression. Plasma levels of soluble fibrin monomer complex (SFMC), D-dimer, and plasminogen activator inhibitor type 1 (PAI-1) were measured at 1 day preoperatively and on postoperative days (PODs) 1, 3, and 7.

RESULTS: The SFMC level showed significant increases on PODs 1 and 3 in the AIS patients and on POD 1 in the LSCS patients. The D-dimer level showed significant increases on PODs 1, 3, and 7 in both groups. The PAI-1 levels showed significant increases on POD 7 in the AIS patients and on PODs 1, 3, and 7 in the LSCS patients.

CONCLUSION: The significantly continuously higher postoperative PAI-1 levels in older patients could be associated with the development and progression of symptomatic VTE.


Keywords


Venous thromboembolism; Adolescent idiopathic scoliosis; D-dimer; Soluble fibrin monomer complex; Plasminogen activator inhibitor type 1

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