Yue L, Fu HY, Sun HL. Acute deep venous thrombosis induced by May-Thurner syndrome after spondylolisthesis surgery: A case report and review of literature. World J Clin Cases 2021; 9(25): 7490-7497 [PMID: 34616817 DOI: 10.12998/wjcc.v9.i25.7490]
Corresponding Author of This Article
Hao-Lin Sun, MD, Associate Professor, Department of Orthopedics, Peking University First Hospital, No. 8 Xishiku Avenue, Beijing 100034, China. sunhaolin@vip.163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2021; 9(25): 7490-7497 Published online Sep 6, 2021. doi: 10.12998/wjcc.v9.i25.7490
Acute deep venous thrombosis induced by May-Thurner syndrome after spondylolisthesis surgery: A case report and review of literature
Lei Yue, Hao-Yong Fu, Hao-Lin Sun
Lei Yue, Hao-Yong Fu, Hao-Lin Sun, Department of Orthopedics, Peking University First Hospital, Beijing 100034, China
Author contributions: Yue L and Fu HY reviewed the literature and contributed to manuscript drafting; Yue L analyzed and interpreted the imaging findings; Sun HL was the patient’s spine surgeon and was responsible for the revision of the manuscript for important intellectual content; All authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was not obtained from the patient for publication because the patient had deceased. The study was approved by ethics committee of our hospital.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hao-Lin Sun, MD, Associate Professor, Department of Orthopedics, Peking University First Hospital, No. 8 Xishiku Avenue, Beijing 100034, China. sunhaolin@vip.163.com
Received: January 30, 2021 Peer-review started: January 30, 2021 First decision: April 25, 2021 Revised: May 4, 2021 Accepted: July 15, 2021 Article in press: July 15, 2021 Published online: September 6, 2021 Processing time: 213 Days and 3.9 Hours
Abstract
BACKGROUND
Deep venous thrombosis (DVT) is a serious complication of lumbar spine surgery. Current guidelines recommend pharmacomechanical prophylaxis for patients at high risk of DVT after spine surgery. May-Thurner syndrome (MTS), a venous anatomical variation that may require invasive intervention, is an often overlooked cause of DVT. To date, no case reports of symptomatic MTS caused by isthmic spondylolisthesis or subsequent acute DVT after posterior lumbar surgery have been published.
CASE SUMMARY
We here present a case of a patient who developed acute DVT 4 h after spondylolisthesis surgery, and MTS was only considered after surgery, during a review of a gynecological enhanced computed tomography image taken before the procedure.
CONCLUSION
In conclusion, clinicians should consider MTS in the presence of a dangerous triad: spondylolisthesis, elevated D-dimer levels, and sonographically indicated unilateral deep vein dilation. Consultation with a vascular surgeon is also essential to MTS management.
Core Tip: The overall prevalence of May-Thurner syndrome (MTS) and its contribution to deep venous thrombosis (DVT) are currently underestimated. We here present a case of acute DVT induced by MTS after lumbar surgery. MTS should be considered in the presence of a dangerous triad (spondylolisthesis, elevated D-dimer levels, and sonographically indicated unilateral deep vein dilation). Consultation with a vascular surgeon is essential to MTS management. A literature review of MTS in spinal settings was also performed.
