Comparison of efficiency and safety of rivaroxaban and subcutaneous enoxaparin in the prevention of venous thromboembolic events after spinal surger

Abstract

posterior lumbar spine surgery is associated with a significant risk for postoperative venous thromboembolism (VTE) and deep venous thrombosis (DVT). Prolonged immobility, obesity, underlying diseases and Possible malignancies are important predisposing factors for developing VTE after posterior lumbar spine surgery. Today, chemical anticoagulants and a wide range of drugs with different efficacy and safety are used. Heparin, warfarin, apixaban, enoxaparin, rivaroxaban, etc. have been clinically used after orthopedic surgery, especially to prevent VTE. However, no comparative report has described the effectiveness and safety of anticoagulant drugs after posterior lumbar spine surge, so the aim of this study is to compare the effectiveness and safety of rivaroxaban and subcutaneous enoxaparin in the prevention of venous thromboembolic events after spinal surgery Methods: 60 patients’ candidate’s posterior lumbar spine surgery were included in the study and divided into two groups, in the first group: 30 patient received oral Rivaroxaban 10 mg twice a day after surgery for one week; the second group: 30 patient received subcutaneous Enoxaparin 40 mg daily for one week after surgery. All the information required for the research, including demographic information, age, gender, duration of surgery, duration of hospitalization, thromboembolic symptoms and secondary outcomes including bleeding during treatment, unexpected hematoma (> 25 cm2) and wound site hematoma during treatment periods and the follow-up was checked. Data were analyzed by SPSS version 20. A P-Value of < 0.05 was considered as statistically significant

Results: In our study, rivaroxaban was superior to enoxaparin and further reduced the incidence of VTE after back and posterior lumbar spine surgery. The risk of bleeding was higher with rivaroxaban compared to enoxaparin ,but this difference was not significant (p=0.46). During the treatment period, there were no known deaths or pulmonary embolisms in the rivaroxaban group and 1 patient had a pulmonary embolism in the enoxaparin group.