Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

No anti-clotting treatment needed for most kids undergoing spine surgeries

15.07.2014

Blood clots occur so rarely in children undergoing spine operations that most patients require nothing more than vigilant monitoring after surgery and should be spared risky and costly anti-clotting medications, according to a new Johns Hopkins Children's Center study.

Because clotting risk in children is poorly understood, treatment guidelines are largely absent, leaving doctors caring for pediatric patients at a loss on whom to treat and when.


Dr. Sponseller and colleagues conducted research to better define the risk of dangerous blood clot formation in children following a common spinal surgery.

Credit: Johns Hopkins Medicine

The Johns Hopkins' team findings, published online July 15 in the journal Spine, narrow down the pool of high-risk patients and should help clinicians better determine which children might benefit from treatment with anti-clotting drugs. Pre-emptive anti-clotting therapy should be considered only in a small subset of patients with a markedly elevated risk for developing dangerous blood clots, the research team says.

These include patients older than 18, children with spinal curvatures present at birth and those with spinal curvatures that are part of an overall syndrome and are accompanied by other underlying medical conditions that may interfere with normal blood clotting.

"Our findings should help clinicians weigh the pros and cons of pre-emptive treatment and focus on those who stand to benefit the most," says senior investigator Paul Sponseller, M.D., M.B.A., chief of pediatric orthopaedics at Johns Hopkins. "Most children undergoing spine surgeries should be perfectly safe without medication. Treatment should be reserved for the handful of patients who have a real risk of developing dangerous clots. In these patients, the benefits of treatment far outweigh the risks."

Overall, blood clots were rare — 21 episodes for 10,000 surgeries, on average — and no patients died as a result of one, the study found. But heightened risk emerged in certain subgroups. Specifically, children with congenital scoliosis — a spinal curvature present at birth — were four times more likely to develop deep-vein clots than other children undergoing spinal surgeries.

Those who underwent surgery to repair spinal fractures were 12 times more likely to develop a clot. Children whose spinal curvature was part of a syndrome were seven times more likely to develop a blood clot than others. Older children were also at increased risk for clot formation, the researchers found, with risk rising 1.2 times per year of age.

The investigators say that children with congenital scoliosis or those with scoliosis that is part of a syndrome tend to have underlying medical conditions that may predispose them to clot formation. The elevated blood clot risk seen among trauma patients, on the other hand, is likely fueled by the prolonged inactivity often required following trauma and surgery.

"Prolonged inactivity impedes blood circulation and can foster clot formation, which can drive up clotting risk in trauma patients following spinal surgery, as some of them tend to have multiple fractures or other injuries that require immobilization for weeks, even moths, on end," says lead investigator Amit Jain, M.D., a third-year orthopaedic surgery resident at Johns Hopkins.

The results of the study are based on a review of surgical outcomes among nearly 22,000 children nationwide who had spinal fusion surgery between 2001 and 2010. Spinal fusion is the most common type of spinal surgery in both children and adults. The two conditions most frequently treated with spinal fusion are spinal fractures and curvatures of the spine.

Clots that form deep in the veins, known as deep vein thrombosis can travel to the lungs where they can clog an artery and cut off vital oxygen supply to the rest of the body. The condition, known as pulmonary embolism, can be quickly fatal and requires emergency treatment.

Signs of deep vein thrombosis include pain, tenderness and swelling at the site of clot formation, usually the leg or arm. Symptoms suggestive of pulmonary embolism include chest pain, rapid and labored breathing, spitting blood, and fainting.

###

Co-investigators on the study included Dominique Karas, M.H.S., and Richard Skolasky, M.A., Sc.D., both of Johns Hopkins.

Ekaterina Pesheva | Eurek Alert!

More articles from Health and Medicine:

nachricht Imaging test may identify biomarker of Alzheimer's disease
27.05.2015 | Radiological Society of North America

nachricht Advance in regenerative medicine
27.05.2015 | Julius-Maximilians-Universität Würzburg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Advance in regenerative medicine

The only professorship in Germany to date, one master's programme, one laboratory with worldwide unique equipment and the corresponding research results: The University of Würzburg is leading in the field of biofabrication.

Paul Dalton is presently the only professor of biofabrication in Germany. About a year ago, the Australian researcher relocated to the Würzburg department for...

Im Focus: Basel Physicists Develop Efficient Method of Signal Transmission from Nanocomponents

Physicists have developed an innovative method that could enable the efficient use of nanocomponents in electronic circuits. To achieve this, they have developed a layout in which a nanocomponent is connected to two electrical conductors, which uncouple the electrical signal in a highly efficient manner. The scientists at the Department of Physics and the Swiss Nanoscience Institute at the University of Basel have published their results in the scientific journal “Nature Communications” together with their colleagues from ETH Zurich.

Electronic components are becoming smaller and smaller. Components measuring just a few nanometers – the size of around ten atoms – are already being produced...

Im Focus: IoT-based Advanced Automobile Parking Navigation System

Development and implementation of an advanced automobile parking navigation platform for parking services

To fulfill the requirements of the industry, PolyU researchers developed the Advanced Automobile Parking Navigation Platform, which includes smart devices,...

Im Focus: First electrical car ferry in the world in operation in Norway now

  • Siemens delivers electric propulsion system and charging stations with lithium-ion batteries charged from hydro power
  • Ferry only uses 150 kilowatt hours (kWh) per route and reduces cost of fuel by 60 percent
  • Milestone on the road to operating emission-free ferries

The world's first electrical car and passenger ferry powered by batteries has entered service in Norway. The ferry only uses 150 kWh per route, which...

Im Focus: Into the ice – RV Polarstern opens the arctic season by setting course for Spitsbergen

On Tuesday, 19 May 2015 the research icebreaker Polarstern will leave its home port in Bremerhaven, setting a course for the Arctic. Led by Dr Ilka Peeken from the Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research (AWI) a team of 53 researchers from 11 countries will investigate the effects of climate change in the Arctic, from the surface ice floes down to the seafloor.

RV Polarstern will enter the sea-ice zone north of Spitsbergen. Covering two shallow regions on their way to deeper waters, the scientists on board will focus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International symposium: trends in spatial analysis and modelling for a more sustainable land use

20.05.2015 | Event News

15th conference of the International Association of Colloid and Interface Scientists

18.05.2015 | Event News

EHFG 2015: Securing health in Europe. Balancing priorities, sharing responsibilities

12.05.2015 | Event News

 
Latest News

Advance in regenerative medicine

27.05.2015 | Health and Medicine

Analytical lamps monitor air pollution in cities

26.05.2015 | Ecology, The Environment and Conservation

DNA double helix does double duty in assembling arrays of nanoparticles

26.05.2015 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>