Table: 3.
Chemoprophylaxis regimen and outcome measures of studies included in the review.
| First author | Publication year | Chemoprophylaxis drug | Route of administration | Dosage | Duration | Additional DVT/PE prophylaxis measure | DVT cases/all patients | Symptomatic DVT cases/all DVT cases | Method of DVT identification | PE cases/all cases | Complications |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Zhao et al. | 2018 | LMWH | NA | 5000 IU/day | Until ambulation | Lower limb exercises | 64/710 | 5/64 | U/S: preoperatively and 7th postoperative day | 2/710 | Death: 1 |
| Guo et al. | 2017 | LMWH | SC | 6 h after surgery: 2125 IU, then 4250 IU/day | 7–14 days or until ambulation | Thigh-high compression stockings with SCD Active straight-leg raising exercise or passive exercise |
2/196: PLIF: 2/98 Intervertebral fusion: 0/98 |
0/2 | U/S: preoperatively, 7th & 14th postoperative day, 4th postoperative week | 0/198 | Allergic reaction to LMWH: 1 SC ecchymosis: 1 Incisional bleeding: 2 Epidural hematoma: 1 |
| Vint et al. | 2021 | LMWH | SC | 4500 IU/day | Starting the evening before surgery; 3–5 days (continued with aspirin) | TEDS for 6 weeks Intermittent pneumatic compression intraoperatively and 24 h after Early mobilization the morning after surgery |
0/200 | 0/0 | Clinically (followed for 52 weeks) | 0/200 | Incisional bleeding/hematoma: 0 GIT bleeding: 0 Retroperitonial hematoma: 0 |
| Li et al. | 2019 | LMWH | NA | 5000 IU/day | NA | Mechanical prophylaxis | 349/1518 | 0/349 | U/S: preoperatively, 1st & 2nd & 4th & 8th & 12th postoperative weeks | 0/1518 | NA |
| Kiguchi et al. (group 1: start of chemoprophylaxis <24 h post-operatively) | 2021 | UH | SC | 5000 IU/day | Median dose: 7 | NA | 2/105 | 2/2 | Clinically (within 30 days of surgery) | 0/105 | Bleeding complication (e.g. epidural or retroperitoneal hematoma): 5 HIT: 1 |
| Kiguchi et al. (group 2: start of chemoprophylaxis >24 h post-operatively) | 2021 | UH | SC | 5000 IU/day | Median dose: 6.5 | NA | 2/70 | 2/2 | Clinically (within 30 days of surgery) | 0/70 | Bleeding complication (e.g. epidural or retroperitoneal hematoma): 5 |
| Yang et al. (Study 1) | 2015 | LMWH | NA | 4100 IU/day | 7 days post-operatively | Mechanical prophylaxis | 97/784; Single level fusion: 79/575 Double level fusion: 38/178 3+ level fusion: 8/31 |
NA | U/S: pre- and post-operatively (exact timing not mentioned, 7th post-operative day mentioned) | 0/784 | Epidural hematoma: 2 |
| Yang et al. (Study 2) | 2015 | LMWH | NA | 4100 IU/day | NA | Mechanical prophylaxis | 223/995, Single level fusion: 156/731 Double level fusion: 51/218 3+ level fusion: 16/46 |
NA | U/S: pre- and post-operatively (exact timing not mentioned) | 0/995 | Epidural hematoma: 1 |
| Weber et al. | 2014 | LMWH | NA | Starting 4–6 h post-operatively | NA | Below the knees TEDS SCD starting preoperatively Early mobilization (postoperative day 1–2 if possible) |
0/40 | 0/0 | Clinically & U/S: 2/3 of patients on 4th or 5th post-operative day |
0/40 | Epidural hematoma: 0 |
| Wei et al. | 2016 | LMWH | SC | 4000 IU/day | Post-operative days 1–7 (if a patient had a positive d-dimer test the first dose was given 12 h pre-operatively) | Intermittent pneumatic compression Mobilization starting on postoperative day 5 |
269/2864 | 0/269 | Clinically (U/S if positive) & U/S: pre-operatively, 5th post-operative day |
0/2864 | Epidural hematoma: 6 |
| Altshuler et al. | 2020 | UH | SC | 5000 IU/8 h | Starting on post-operative day 1, duration NA | SCD Early mobilization (postoperative day 1 if possible) |
7/596, Minimally invasive group: 3/406 Open group: 4/190 |
7/7 | Clinically | 3/596, Minimally invasive group: 0/406 Open group: 3/190 |
NA |
| Bai et al. | 2019 | LMWH | SC | NA | Starting 24 h post-operatively, duration NA | Passive mobilization | 78/277 | NA | NA (patients followed for 12–48 months) | 2/277 | GIT bleeding: 12 Cerebral bleeding: 1 Death: 1 |
| Liu et al. | 2017 | LMWH | NA | 4100 IU/day | NA | Limb exercise | 13/140 | 0/13 | U/S: pre- and post-operatively (timing not mentioned) | 0/140 | Epidural hematoma: 0 |
DVT: deep vein thrombosis; PE: pulmonary embolism; LMWH: low molecular weight heparin; NA: not available; U/S: ultrasound; SC: subcutaneous; IU: international units; SDC: sequential compression device; PLIF: posterior lumbar interbody fusion; TEDS: thromboembolic deterrent stockings; GIT: gastrointestinal tract; UH: unfractionated heparin; HIT: heparin induced thrombocytopenia.