APPENDIX A
Surgeon Name:__________________________________________
SPINE SURGEON QUESTIONNAIRE ON THROMBOPROPHYLAXIS FOLLOWING SPINAL TRAUMA
Which is your surgical background? Orthopaedic
What is your weekly spine trauma volume? <1
Neurosurgery
<5
Both
6-10
>10
Does your institution have a DVT prophylaxis protocol for general trauma patients? Yes
Is this protocol inclusive of spinal cord injury(SCI) patients? Yes
Which lab values do you routinely obtain? INR
D-dimers
No
No
PT/PTT
Bleeding time
None
Which form of DVT prophylaxis do you normally utilize in PRE-OP spinal trauma patients with SCI?
None
TEDs/SCDs
LMWH
Heparin
Warfarin
Special circumstances? Explain: _________________________
Which form of DVT prophylaxis do you normally utilize in PRE-OP spinal trauma patients without SCI?
None
TEDs/SCDs
LMWH
Heparin
Warfarin
Special circumstances? Explain: _________________________
Which form of DVT prophylaxis do you normally utilize in POST-OP spinal trauma patients with SCI?
None
TEDs/SCDs
LMWH
Heparin
Warfarin
Special circumstances? Explain: _________________________
Which form of DVT prophylaxis do you normally utilize in POST-OP spinal trauma patients without SCI?
None
TEDs/SCDs
LMWH
Heparin
Warfarin
Special circumstances? Explain: _________________________
Which postoperative day do you routinely start pharmacological prophylaxis? (TRAUMA with SCI)
POD#0-2
POD#3-7
POD#8-14
>POD#15
Which postoperative day do you routinely start pharmacological prophylaxis? (TRAUMA without SCI)
POD#0-2
POD#3-7
POD#8-14
>POD#15
How long do you typically recommend DVT prophylaxis POST-OP? (TRAUMA with SCI)
2 wks
6 wks
>6 wks
Depends on mobility
How long do you typically recommend DVT prophylaxis POST-OP? (TRAUMA without SCI)
2 wks
6 wks
>6 wks
Depends on mobility
What are your indications for an IVC filter? (Check all that apply)
Solid organ injury
Bleeding disorder
SCI
Anterior TL surgical approach
Have you treated spine complications from LMWH prophylaxis? Yes
Other
_________________________
No
Have any of your patients treated with LMWH prophylaxis experienced bleeding requiring operative intervention?
Yes
No
If yes, explain:__________________________________________________________________
Have you noticed more wound complications with LMWH prophylaxis?
Have any of your patients died from fatal PE after spine surgery?
Yes
Yes
No
No
Which is your preferred DVT prophylaxis in ELECTIVE anterior thoracolumbar spine cases POST-OP?
None
TEDs/SCDs
LMWH
Heparin
Warfarin
Special circumstances? Explain: _________________________
Which is your preferred DVT prophylaxis in ELECTIVE posterior thoracolumbar spine cases POST-OP?
None
TEDs/SCDs
LMWH
Heparin
Warfarin
Special circumstances? Explain: _________________________
Which is your preferred DVT prophylaxis in ELECTIVE anterior cervical spine cases POST-OP?
None
TEDs/SCDs
LMWH
Heparin
Warfarin
Special circumstances? Explain: _________________________
Which is your preferred DVT prophylaxis in ELECTIVE posterior cervical cases (multilevel laminectomy) POST-OP?
None
TEDs/SCDs
LMWH
Heparin
Warfarin
Special circumstances? Explain: _________________________
Do you routinely use any of these intraoperative measures to minimize POST-OP bleeding? (Check all that apply)
FloSeal/SurgiFlo
Tisseal/DuraSeal
Gelfoam/Thrombin
TissueLink
Other___________________________________