{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:28:28Z","timestamp":1787761708707,"version":"build-2784847793"},"reference-count":15,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Lumbar spinal stenosis (LSS) is a disabling degenerative process of the spine, mainly affecting older patients. LSS manifests with low-back and leg pain and neurogenic claudication. Disability and impairment in activities of daily living are consequences of the progressive narrowing of the lumbar spinal canal. Surgical decompression has been shown to be superior to conservative management. Nonetheless, intraoperative and postoperative blood loss in elderly patients taking antiplatelet or anticoagulant drugs owing to cardiovascular comorbidities may be a special issue. This study describes and compares early outcomes after surgical procedures in different groups of patients receiving antithrombotic drugs.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors\u2019 study retrospectively recruited 289 consecutive patients aged \u2265 65 years who received lumbar decompression for spinal stenosis between January 2021 and May 2022. First, 183 patients taking antiplatelet therapy were divided into two groups according to the rationale for use: primary versus secondary prophylaxis of cardiovascular events (group 1 vs group 2). Primary prevention was stopped preoperatively, or secondary prevention was not discontinued during the perioperative period. Secondly, 106 patients who were not taking antiplatelet mediation were divided into two groups, depending on whether preoperative low-molecular-weight heparin had not been administered or had been (group A vs group B). Intraoperative blood loss, surgical time, and postoperative hospitalization were analyzed.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>No significant statistical differences were observed between groups 1 and 2 in terms of intraoperative blood loss and time of surgery, or between groups A and B in terms of all analyzed variables. No early or delayed complications were observed, perioperatively or during the postoperative 3-month follow-up period.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The results of this study suggest that the use of anticoagulant and antiplatelet therapies in elective decompressive surgery could be devoid of early complications and could be safely continued perioperatively.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.8.spine221332","type":"journal-article","created":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T01:47:41Z","timestamp":1698457661000},"page":"125-131","source":"Crossref","is-referenced-by-count":5,"title":["Antithrombotic therapy and spinal surgery: a retrospective cohort study of 289 consecutive elderly patients with degenerative lumbar stenosis"],"prefix":"10.3171","volume":"40","author":[{"given":"Giuseppe","family":"Corazzelli","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, \"Federico II\" University, Naples, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Capece","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Marche Polytechnic University, Ancona, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Pizzuti","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Settimio","family":"Leonetti","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"D\u2019Elia","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Santilli","sequence":"additional","affiliation":[{"name":"Neurology, IRCCS Neuromed, Pozzilli (IS), Italy; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulvio","family":"Aloj","sequence":"additional","affiliation":[{"name":"Anaesthesiological Department, IRCCS Neuromed, Pozzilli (IS), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gualtiero","family":"Innocenzi","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"8","key":"b1","series-title":"N Engl J Med","first-page":"818","article-title":"Clinical practice. Lumbar spinal stenosis","volume":"358","author":"Katz JN","year":"2008","unstructured":"Katz JN, Harris MB. Clinical practice. Lumbar spinal stenosis. N Engl J Med. 2008;358(8):818\u2013825."},{"key":"b2","series-title":"BMJ","first-page":"h6234","article-title":"Management of lumbar spinal stenosis","volume":"352","author":"Lurie J","year":"2016","unstructured":"Lurie J, Tomkins-Lane C. Management of lumbar spinal stenosis. BMJ. 2016;352:h6234."},{"key":"b3","series-title":"Clin Neurol Neurosurg","first-page":"106792","article-title":"Optimal timing of post-operative enoxaparin after neurosurgery: A single institution experience","volume":"207","author":"Briggs RG","year":"2021","unstructured":"Briggs RG, Lin YH, Dadario NB,  Optimal timing of post-operative enoxaparin after neurosurgery: A single institution experience. Clin Neurol Neurosurg. 2021;207:106792."},{"issue":"22","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"2940","article-title":"The Oswestry disability index.","volume":"25","author":"Fairbank JC","year":"2000","unstructured":"Fairbank JC, Pynsent PB. The Oswestry disability index. Spine (Phila Pa 1976). 2000;25(22):2940\u20132952."},{"issue":"21","key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"1919","article-title":"Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images","volume":"35","author":"Schizas C","year":"2010","unstructured":"Schizas C, Theumann N, Burn A,  Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images. Spine (Phila Pa 1976). 2010;35(21):1919\u20131924."},{"key":"b6","series-title":"Anticoagulation and Hemostasis in Neurosurgery","first-page":"297","article-title":"Safe strategies for gradual suspension and reinstitution of anticoagulation to permit elective surgery","author":"Roark C","year":"2016","unstructured":"Roark C. Safe strategies for gradual suspension and reinstitution of anticoagulation to permit elective surgery. In: Loftus CM, ed. Anticoagulation and Hemostasis in Neurosurgery. Springer; 2016:297-307."},{"issue":"7","key":"b7","series-title":"Spine (Phila Pa 1976)","first-page":"853","article-title":"Deep vein thrombosis after major reconstructive spinal surgery.","volume":"21","author":"Rokito SE","year":"1996","unstructured":"Rokito SE, Schwartz MC, Neuwirth MG. Deep vein thrombosis after major reconstructive spinal surgery. Spine (Phila Pa 1976). 1996;21(7):853\u2013859."},{"issue":"2 Suppl","key":"b8","series-title":"Chest","first-page":"e326S","article-title":"Peri-operative management of antithrombotic therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"Douketis JD","year":"2012","unstructured":"Douketis JD, Spyropoulos AC, Spencer FA,  Peri-operative management of antithrombotic therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e326S\u2013e350S."},{"key":"b9","article-title":"Anticoagulation and Hemostasis in Neurosurgery","year":"2016","unstructured":"Loftus CM, ed. Anticoagulation and Hemostasis in Neurosurgery. Springer;2016."},{"issue":"Suppl 1","key":"b10","series-title":"Anaesthesia","first-page":"58","article-title":"Management of peri-operative antithrombotic therapy","volume":"70","author":"van Veen JJ","year":"2015","unstructured":"van Veen JJ, Makris M. Management of peri-operative antithrombotic therapy. Anaesthesia. 2015;70Suppl 1:58-67,e21-53."},{"issue":"3","key":"b11","series-title":"J Card Surg","first-page":"247","article-title":"Does the use of preoperative aspirin increase the risk of bleeding in patients undergoing coronary artery bypass grafting surgery? Systematic review and meta-analysis","volume":"22","author":"Alghamdi AA","year":"2007","unstructured":"Alghamdi AA, Moussa F, Fremes SE. Does the use of preoperative aspirin increase the risk of bleeding in patients undergoing coronary artery bypass grafting surgery? Systematic review and meta-analysis. J Card Surg. 2007;22(3):247\u2013256."},{"issue":"35","key":"b12","series-title":"Eur Heart J","first-page":"2383","article-title":"2014 ESC\/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA)","volume":"35","author":"Kristensen SD","year":"2014","unstructured":"Kristensen SD, Knuuti J, Saraste A,  2014 ESC\/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J. 2014;35(35):2383\u20132431."},{"issue":"suppl 2","key":"b13","series-title":"Br J Anaesth","first-page":"ii74","article-title":"New antiplatelet drugs and new oral anticoagulants","volume":"117","author":"Koenig-Oberhuber V","year":"2016","unstructured":"Koenig-Oberhuber V, Filipovic M. New antiplatelet drugs and new oral anticoagulants. Br J Anaesth. 2016;117(suppl 2):ii74\u2013ii84."},{"issue":"2","key":"b14","series-title":"JACC Cardiovasc Interv","first-page":"131","article-title":"Perioperative management of patients with drug-eluting stents","volume":"3","author":"Abualsaud AO","year":"2010","unstructured":"Abualsaud AO, Eisenberg MJ. Perioperative management of patients with drug-eluting stents. JACC Cardiovasc Interv. 2010;3(2):131\u2013142."},{"issue":"7","key":"b15","series-title":"Spine J","first-page":"625","article-title":"Treatment of lumbar spinal stenosis: a balancing act","volume":"10","author":"Deyo RA","year":"2010","unstructured":"Deyo RA. Treatment of lumbar spinal stenosis: a balancing act. Spine J. 2010;10(7):625\u2013627."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/40\/2\/article-p125.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/40\/2\/article-p125.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/40\/2\/article-p125.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:16:49Z","timestamp":1733491009000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/40\/2\/article-p125.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,1]]},"references-count":15,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2023.8.spine221332","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2024,2,1]]}}}