Table 5 Clinical scenarios employed in questionnaires with thromboprophylaxis regimens advocated by NICE and pertinent points of consideration
Patient | Diagnosis | Procedure | Prophylaxis | Justification for pharmacological therapy |
|---|---|---|---|---|
Emergency | Â | Â | Â | Â |
44 female BMI 38 | Cauda Equina | Discectomy | TED LMWH IPC | Raised BMI |
65 male | Metastatic Ca | Posterior stabilisation T7-L1 | TED LMWH IPC | Active malignancy |
Elective | Â | Â | Â | Â |
33 male | Disc Prolapse | L5/S1 Discectomy | TEDs IPC | May consider LMWH if surgery/anaesthetic duration > 90 min |
72 female, DM & HTN | Spinal Canal stenosis | L2-L5 lumbar decompression | TEDs IPC LMWH | Medical co-morbidities |
Trauma | Â | Â | Â | Â |
24 male | Burst L1 | Posterior Stabilisation | TEDs IPC LMWH | May consider LMWH if duration of anaesthetic/surgery > 90 min |
36 female | Unifacetal fracture subluxation | Decompression and fusion | TEDs IPC LMWH | May consider LMWH duration of anaesthetic/surgery > 90 min add LMWH |
18 female | Boney Chance # | 6 weeks bed rest 6 weeks brace | TEDs IPC LMWH | Prolonged immobility |
52 male | TB and spinal cord compression | Anterior vertebrectomy T6; posterior instrumentation T4-T8 one wk later | TEDs IPC LMWH | Acute infectious diseases or inflammatory condition |