In an earlier post we talked about the complications that may arise after undergoing back surgery. Today we will delve into one of them is deep vein thrombosis and pulmonary thromboembolism. You’ll understand.
The blood circulates through our body thanks to the heart, the arteries and the veins. The heart pumps the blood to drive it through the system of pipes that are the arteries and veins that carry the blood through the body. Blood has many functions like bringing oxygen through the body to the tissues that need it or bringing the defenses to the areas where they are needed. It also has a repair function. When we have a wound for example, the blood coagulates where there is a leak to plug and repair the defect. The clotting mechanism causes the blood to become solid. If this happens by mistake inside the vein, it obstructs the normal flow of blood. This is called thrombosis. Let’s see why we can have a thrombosis after back surgery and what consequences it may have.
Why can we have a thrombosis after back surgery?
There are several factors that predispose to blood forming thrombi in the veins. Among them are immobility and surgeries. Earlier he said that the heart pumped blood to circulate through the body. This is true but it is not the only one. Muscles when contracted squeeze the veins and propel the contents by helping blood circulation. Without this aid the blood can coagulate by staying stagnant and not progressing. This is what happens when we are long bedded, for example.
Long surgeries such as spinal surgery and the fact of undergoing anesthesia favor the formation of thrombi but are not the only factors. There are risks that go with the person’s medical situation. Advanced age, the presence of other diseases such as a heart problem or cancer and alterations in the blood itself are factors that may favor thrombosis.
Blood changes that promote thrombosis are often not known. Sometimes surgery is the factor that precipitates the thrombosis and then it is discovered that there was a predisposition for an illness of the blood not known. This is rare but sometimes occurs.
What can happen to me if I have a thrombosis after surgery?
The most typical site of thrombus formation is in the leg. If a thrombus forms in the deep veins of the leg, the flow of blood is obstructed and the leg tends to swell, to have edema. It is typical that the fingers stay marked if we press. It can also be red and have pain as if we had hurt a muscle. It is characteristic that there is an asymmetry of one leg with the other. At other times it even produces no visible symptoms and goes unnoticed. This problem is called deep vein thrombosis or DVT.
DVT is a localized problem, usually in the leg, that can have consequences in the venous system and generates problems of venous insufficiency in the future or varices (so that we understand each other). The problem is local and not particularly serious. The serious problem comes when the thrombus detaches itself from the vein wall and travels through the vascular tree until it encounters a stop where it becomes stuck like a plunger.
And what is this cap? Veins collect blood from body tissues that have already consumed the oxygen it carries. In other words, the blood goes to the muscle, it consumes oxygen and the blood, without oxygen, leaves the muscle through the veins. The veins go to the right side of the heart that pushes the blood to the lung to re-oxygenate. This is where the thrombus gets trapped. Being trapped here because it cannot fit and cannot pass, it blocks all blood circulation. This causes blood to not reach the corresponding areas of the lung and these areas die. A lung infarction occurs. This is what we call pulmonary thromboembolism or PE. This complication is very serious and can lead to death of the patient.
How is thrombosis prevented after a back surgery?
Fortunately today we have a weapon against this problem. They are the anticoagulants. Within these are those we call low molecular weight heparins which are quite safe and are given with a subcutaneous injection. Our surgeon, after surgery, will indicate this injection once a day for a time that is variable depending on the patient and the surgery performed.
With the administration of this medication greatly decreases the risk of suffering a DVT or a PET but does not completely eliminate it. Therefore, if we have symptoms of a possible PTS, we must go to the emergency room. These symptoms are high fevers, chest pain; if we lack the air, important cough without being coughing, cough with blood and of course if we have suffered a faint. We should also go to the doctor if we have the symptoms that we mentioned before suggestive of venous thrombosis.
One question that may arise is whether you can have a PET without having a DVT. The answer is yes. In fact in a third of pulmonary thromboembolism no lesion is found in the deep venous system. That is, you can suffer the lung injury without noticing symptoms in the leg.
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