Utility of Preoperative Deep-vein Thrombosis Screening with Doppler Ultrasound in Lumbosacral Spine Surgery: A Prospective Study

Background: Deep-vein thrombosis (DVT) is a serious complication of spine surgery, with the potential to cause fatal pulmonary embolism. The value of routine preoperative screening with Doppler ultrasound remains controversial and relatively understudied. Objective: To determine the prevalence of lower-extremity DVT in patients undergoing elective lumbosacral spine surgery. Material and Methods: A cross-sectional prospective study was conducted on 114 consecutive patients scheduled for elective lumbosacral spine surgery at our institution. All patients underwent bilateral lower-extremity Doppler ultrasonography (DUS) prior to surgery. Demographic data and comorbidities were recorded and analyzed. Results: The mean age of patients was 54.5 ± 12.1 years, and 68.4% were female. Preoperative DUS detected DVT in only one patient (0.9%), who had a history of malignancy. Surgery was canceled, and anticoagulation therapy was initiated. No other patients showed evidence of thrombosis. A secondary aim of the study was to explore the potential risk factors for DVT, if a sufficient number of DVT-positive cases were identified. However, since only one case was detected, meaningful statistical analysis was not feasible. Conclusion: In this study, the prevalence of preoperative DVT in elective lumbosacral spine surgery patients was extremely low (0.9%). Our findings suggest that routine preoperative Doppler screening has limited value in the general spine surgery population. However, screening should be considered for high-risk patients. As this remains a relatively understudied topic, further research is warranted to define optimal screening strategies.