Pulmonary Embolism as a Complication Following Anterior Cervical Discectomy and Fusion in a Patient with a History of COVID-19: A Case Report and Literature Review

This is a case report of an otherwise healthy 45-year-old male patient with a history of COVID-19, who later underwent an Anterior Cervical Spine Decompression and Fusion of level three to four for progressing neurological symptoms. The patient was readmitted eleven days postoperatively for shortness of breath and found to have a Pulmonary Embolism. The patient was at low risk for postoperative VTE, with no known current significant risk factors. He had a history of COVID-19, along with lab values and imaging that have been shown in other case series to help support the link between covid-19 and hypercoagulable state. We hope to support this hypothesis, and bring light to future larger scale studies, in order to better understand this disease and effectively create a preoperative assessment to identify such patients at risk, along with post-operative protocols for these patients having procedures in the future. To our knowledge, this is the first reported case of confirmed postoperative DVT/PE in an otherwise low-risk patient, who had a history of COVID-19 with full recovery. The rarity of this complication, along with options for how to risk-stratify these patients should be formally addressed, especially in those who require urgent spine surgery. These options are discussed, reviewed, and remarks as to where further attention and research is needed is addressed.