naa a22 4500 510760139 CHVBK 20180411083136.0 cr unu---uuuuu 180411e20130201xx s 000 0 eng 10.1007/s11420-012-9318-4 doi (NATIONALLICENCE)springer-10.1007/s11420-012-9318-4 Thrombophilic Abnormalities in Patients With or Without Pulmonary Embolism Following Elective Spinal Surgery [Elektronische Daten] A Pilot Study [Suhel Kotwal, Satoshi Kawaguchi, Alexander Hughes, Frank Cammisa Jr., Kai Zhang, Eduardo Salvati, Federico Girardi] Background: Significance of the thrombophilic abnormalities in development of venous thromboembolism (VTE) has been studies with total hip arthroplasty and acute traumatic spinal cord injury. However, their role as risk factors for VTE in elective spinal surgery remains to be determined. Questions/Purposes: To determine the role of thrombophilic abnormalities in the development of pulmonary embolism (PE) following elective spine surgery. Methods: Case and control groups were created in patients who had undergone elective spinal surgery for degenerative conditions. The PE group comprised 12 patients whose post-operative course was complicated by development of PE. The control group included 12 patients with an uneventful post-operative course. Demographic data including age, gender and surgical procedures were matched between the PE group and the control group. Both groups were evaluated for thrombophilic and hypofibrinolytic risk factors at 3months post-operatively or later. Blood tests were performed to measure fasting serum homocysteine, antithrombin III, and protein C. Molecular genetic testing was conducted for detection of the plasminogen activator inhibitor-1 4G/4G, and prothrombin 3 UTR gene mutations. Results: Heterozygous mutation (G20201A) of prothrombin was detected in two patients (16.7%) in the PE group, whereas no such mutation was noted in the control group. Plasminogen activator inhibitor-1 4G/4G homozygous mutation was seen in three in the PE group and two in the control group. Of homocysteine, antithrombin III and protein C, only one patient in each group showed abnormal levels of homocysteine. In total, there half of the patients in the PE group had at least one thrombophilic abnormality, whereas three (25%) patients showed such abnormality in the control group. Conclusion: These findings suggest the involvement of thrombophilic abnormalities, especially the heterozygous G20201A mutation, in the development of PE in patients undergoing elective spinal surgery. Hospital for Special Surgery, 2013 pulmonary embolism nationallicence venous thromboembolism nationallicence elective spinal surgery nationallicence thrombophilia nationallicence gene mutation nationallicence Kotwal Suhel Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut Kawaguchi Satoshi Department of Orthopaedic Surgery, Sapporo Medical University, South 1, West 16, 060-8543, Sapporo, Japan aut Hughes Alexander Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut Cammisa Jr. Frank Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut Zhang Kai Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut Salvati Eduardo Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut Girardi Federico Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut HSS Journal ® Springer-Verlag 9/1(2013-02-01), 32-35 1556-3316 9:1<32 2013 9 11420 https://doi.org/10.1007/s11420-012-9318-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11420-012-9318-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kotwal Suhel Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut NATIONALLICENCE 700 1- Kawaguchi Satoshi Department of Orthopaedic Surgery, Sapporo Medical University, South 1, West 16, 060-8543, Sapporo, Japan aut NATIONALLICENCE 700 1- Hughes Alexander Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut NATIONALLICENCE 700 1- Cammisa Jr Frank Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut NATIONALLICENCE 700 1- Zhang Kai Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut NATIONALLICENCE 700 1- Salvati Eduardo Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut NATIONALLICENCE 700 1- Girardi Federico Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut NATIONALLICENCE 773 0- HSS Journal ® Springer-Verlag 9/1(2013-02-01), 32-35 1556-3316 9:1<32 2013 9 11420 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer