When indicated, how long should mechanical prophylaxis continue following spinal surgery?
Although evidence in the spine literature is limited regarding timing and duration of mechanical prophylaxis, initiation of mechanical compression just prior to or at the beginning of surgery and continuation until the patient is fully ambulatory is a reasonable practice. While several studies cited start and stop times consistent with this recommendation, no studies specifically assessed this issue in a comparative fashion. Grade of Recommendation: Work Group Consensus Statement • Chemoprophylaxis The utility and safety of chemoprophylaxis following spinal surgery is controversial. Because of the hazardous risk of symptomatic epidural hematoma, the potential consequences may confound the benefits of these agents. Unfortunately, scientific scrutiny of chemoprophylaxis in elective spinal surgery has been limited to case series involving discectomy and decompression. Evidence is better established in higher risk patients undergoing spinal surgery for traumatic or neoplastic conditions, a
