OBJECTIVES: Venous thromboprophylaxis consisting of chemical and/or mechanical prophylaxis is administered to patients undergoing adult spinal deformity (ASD) surgery to prevent venous thromboembolic events. However, the true incidence of venous thromboembolism (VTE) after these surgeries is unknown resulting in weak recommendations regarding type and timing of prophylaxis in these patients. A systematic literature review was conducted to examine VTE incidence in addition to optimal type and timing of VTE prophylaxis.

METHODS: A detailed search was carried out on Embase, PubMed, and Cochrane Library databases through October 18, 2017 for studies that evaluated VTE outcomes, type, and timing of prophylaxis administration among ASD surgery patients who were on VTE prophylaxis.

RESULTS: Three articles published between 1996 and 2008 met the inclusion criteria. Average age of the 537 patients was 48 years comprising 86.2% females and 13.8% males. There were 583 reconstructive surgeries reported. Incidence of VTE ranged from 1.00% to 14.0% in the different the study types which employed varied thromboprophylaxis. VTE prophylaxis was initiated before surgery in 87.7% patients and intra-operatively in 12.3% patients. The studies were heterogenous and no pooled analysis was conducted.

CONCLUSIONS: Heterogeneity within the few studies in this present study suggests that more studies are still required to assess the true incidence of VTE, optimal type and timing of the use of thromboprophylaxis for surgery in ASD patients.