Risk Factors Analysis Of Lower Extremity Venous Thrombosis In Patients With Lumbar Degenerative Disease Treated With MIS-TLIF

Objective: To explore the epidemiological characteristics of lower extremity deep venous thrombosis(deep venous thrombosis,DVT)after minimally invasive transforaminal interbody fusion(minimally invasive surgery-transforaminal lumbar interbody fusion,MIS-TLIF)in patients with lumbar degenerative diseases treated by spinal surgery in the people’s Hospital of Guangxi Zhuang Autonomous region.Logistic regression multivariate analysis was used to screen related risk factors.To provide vigilance and clinical basis for spinal surgeons with deep venous thrombosis of lower extremities after the operation and to establish a predictive model of thrombosis after MIS-TLIF.Methods: a cross-sectional study was conducted to collect 172 inpatients with lumbar degeneration who underwent MIS-TLIF operation in the Department of Spinal Surgery of Guangxi Zhuang Autonomous region people’s Hospital from January 2022 to January 2023.Collect the relevant information on symptoms,signs,operation process,and blood indexes during the perioperative period of hospitalization.According to the results of the postoperative color Doppler ultrasound diagnosis of both lower extremities venous thrombosis,the patients were divided into DVT group and non-DVT group.The age,sex,body mass index,coronary heart disease,hypertension,previous cerebral infarction history,postoperative blood examination index,renal function,surgical fusion segment,intraoperative blood loss,and thrombus site and lower limb symptoms were compared between the two groups.Univariate analysis.The independent risk factors of lower extremity venous thrombosis were tested by Logistic regression analysis,and the visual line map of the selected independent risk factors was drawn under R,and the model was verified by calibration curve,subject working characteristic curve,and decision curve.Results: 1.A total of 172 patients with lumbar spinal stenosis were included in this study.among them,52 patients were complicated with lower limb thrombosis after MIS-TLI operation.The incidence of lower limb thrombosis after the operation was 30.2%.The site of thrombosis was intermuscular vein thrombosis(100%).It is often highly associated with the affected limb with movement limitation and pain before the operation(91%).2.MIS-TLIF treatment of lumbar degeneration patients with postoperative lower limb thrombosis and gender,history of cerebral infarction,duration of lower limb movement limitation symptoms,time of use of anticoagulants,postoperative bed rest for more than 3 days,postoperative C-reactive protein and Dmur2 polymer,the results of the univariate analysis showed that the difference was statistically significant.Among them,the history of cerebral infarction,the time of lower limb symptoms,and D-Dimer can be used as independent risk factors for lower limb thrombosis after this operation.3.Three independent risk factors were included in the model to establish a risk prediction model for venous thrombosis of lower extremities in the short term after MIS-TLIF.Conclusion: 1.In this study,it was found that in this study,the incidence of deep venous thrombosis after lumbar MIS-TLIF was 30.2%,mainly single intermuscular venous thrombosis in one limb,and highly associated with symptomatic affected limbs.Sex,previous history of cerebral infarction,lower limb symptom time,and anticoagulant use time are the risk factors of lower extremity deep venous thrombosis after intervertebral foramen interbody fusion.In the clinical work for patients with lumbar spinal stenosis,targeted treatment should be carried out according to the above factors to avoid the formation of lower extremity deep venous thrombosis after lumbar vertebra operation.two.The history of cerebral infarction,the time of lower limb symptoms,and D-Dimer can be used as independent risk factors for lower limb thrombosis after this operation.3.The risk prediction model of lower extremity venous thrombosis in the short-term after MIS-TLIF can be used to predict lower limb venous thrombosis in the short-term after spinal surgery in Guangxi Zhuang Autonomous region people’s Hospital.It provides a basis for early intervention for patients with lumbar degeneration as early as possible.