Pulmonary Embolism (PE) is a rare but serious event that may occur after spinal surgery. Vascular endothelial damage during surgery and immobilization of the patient after surgery contribute to a higher risk of thrombosis and subsequent PE. Prophylaxis including intermittent pneumatic compression stockings, heparin, and other interventions is often employed by the treatment team to lower the risk of thromboembolic complications. In orthopedic, trauma, burn and other high-risk surgical patients, the incidence of PE has been thoroughly studied, and this knowledge has been used to establish prophylaxis guidelines specifically for these patients. The incidence of PE in spinal fusion patients, however, is less well studied, and definitive prophylaxis guidelines are lacking. The aim of this article is to review what is known about the incidence of PE in spinal arthrodesis patients, and describe the need for better medical evidence and prevention guidelines on this issue.

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