The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

A Comparison between Enoxaparin and Aspirin in Preventing Deep Vein Thrombosis after Spine Surgery: A Randomized Clinical Trial

Document Type : RESEARCH PAPER

Authors
Amir Kavian 1
Hamid Rezaee 1
Seyedeh Fatemeh Darvari 2
Hassan Mehrad -Majd 3
Hosein Mashhadinejad 1
1 Department of Neurosurgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3 3 Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran 4 Clinical Research Development Unit, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/abjs.2024.74693.3458
Abstract
Objectives: Deep Vein Thrombosis (DVT) is a significant medical concern characterized by the 
formation of blood clots within the venous system. Surgical procedures are known to increase the risk 
of DVT. While enoxaparin has proven to be highly effective in treating DVT, co ncerns about bleeding 
and accurate dosage regulation may restrict its application. Recent research has focused on aspirin's 
potential in preventing DVT after various surgeries. This study aimed to determine whether aspirin was 
as effective as enoxaparin in preventing DVT after spine surgery.
Methods: This randomized controlled trial enrolled study patients who underwent spine surgery at Shahid Kamyab 
Emergency Hospital in Mashhad, and had a Caprini score > 5, indicating a higher risk of DVT. In the control group, 
patients received subcutaneous injections of enoxaparin at a dosage of 40 mg, while the intervention group received 
oral aspirin tablets with a daily dosage of 81 mg. An experienced radiologist performed a Doppler ultrasound of the 
lower limbs' veins seven days after surgery to diagnose DVT. The outcomes of the two groups were then compared.
Results: A total of 100 patients participated in the clinical trial and were equally assigned to the aspirin and 
enoxaparin groups. Both groups were homogeneous regarding the basic and clinical characteristics. The incidence 
of postoperative DVT was 4.0% in the aspirin group and 10.0% in the enoxaparin group (p=0.092). The incidence 
of hemorrhage was 2.0% in the aspirin group and 4.0% in the enoxaparin group (p=0.610).
Conclusion: These findings indicate that aspirin may be a promising alternative to enoxaparin for DVT prevention 
after surgery, but additional research is essential to validate these results and further assess the benefits and risks 
associated with aspirin usage in this context.
 Level of evidence: II
Keywords
Aspirin
Deep vein thrombosis
Enoxaparin
Prophylaxis
Spine surgery
Subjects
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The Archives of Bone and Joint Surgery
Volume 12, Issue 6
June 2024
Pages 412-417

  • Receive Date 31 August 2023
  • Revise Date 22 April 2024
  • Accept Date 06 April 2024