Laminectomy with 2 level fusion -- history of deep vein thrombosis

[Richard Deringer]

I will be having a laminectomy with L4, L5 and L1 fusion this Tuesday. My GP is concerned because I have had DVT on two occasions, both when imbolized for long periods of time. My surgeon does not use anticoagulants post surgery. I will wear the compression socks and will be doing as much walking as possible when I come home. Have any of you been in a similar situation or have any advice? Hoping for a response. Thanks, Rich

[Justin]

Hi Rich,

I hope you are doing well. Since you have a history of DVT, you are at increased risk for another DVT. Does your surgeon know of your previous DVTs? If so, I think your significant history would result in your surgeon changing his "standard" post-op treatment plan. I would make sure everyone is on the same page regarding your past medical history, especially since your GP is concerned (and for good reason). Are you able to touch base with your surgeon before your operation next week?

Please keep us posted.

I will be having a laminectomy with L4, L5 and L1 fusion this Tuesday. My GP is concerned because I have had DVT on two occasions, both when imbolized for long periods of time. My surgeon does not use anticoagulants post surgery. I will wear the compression socks and will be doing as much walking as possible when I come home. Have any of you been in a similar situation or have any advice? Hoping for a response. Thanks, Rich

[Richard Deringer]

My GP was concerned over my past two incidents of DVT--both while ambulatory, and my upcoming laminectomy with two level fusion. He made an appointment for me to see a Hematology specialist who reviewed my situation and called my surgeon to recommend that I be put on low weight molecular heparin following the surgery. There will be a slight chance of excessive bleeding but I feel that the risk of DVT is greater.

[laid up doc]

while i am not a surgeon, i deal with PE's and DVT's all the time in my specialty...

low molecular weight heparin is used ALL the time pre- and post-op in high risk patients. definitely talk to your PCP and push your surgeon on this. there really is a lot less bleeding than you'd think in these surgeries... i tend to agree with your risk/benefit assessment, but you really have to talk to the surgeon.

did you have a full workup at the hematologist's when you had the other clots? and was the blood work ALL done before they started you on warfarin/coumadin?

i have a funny family history ONLY and was on enoxaparin for 1 month post-op... again, little risk to prevent something very bad.