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

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 > ۵, indicating a higher risk of DVT. In the control group, patients received subcutaneous injections of enoxaparin at a dosage of ۴۰ mg, while the intervention group received oral aspirin tablets with a daily dosage of ۸۱ 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 ۱۰۰ 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 ۴.۰% in the aspirin group and ۱۰.۰% in the enoxaparin group (p=۰.۰۹۲). The incidence of hemorrhage was ۲.۰% in the aspirin group and ۴.۰% in the enoxaparin group (p=۰.۶۱۰).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