Deep Vein Thrombosis Risk Following a Spinal Cord Injury

Any serious spinal cord injury can have a life changing and traumatic impact on the individual. Whilst we tend to focus on loss of movement and sensation when it comes to these types of injuries, it’s important to note that there are generally other, secondary complications that can be just as challenging to cope with.

These secondary complications include problems with bowel and bladder function as well as issues such as autonomic dysreflexia and spasticity.

Another potential problem that can occur as a result of lack of mobility is the increased risk of deep vein thrombosis (DVT), particularly in the acute stages of a spinal cord injury.

Here we take a look at what deep vein thrombosis is and how individuals with a spinal cord injury can reduce their risk of this potentially life-threatening health condition.

What is Deep Vein Thrombosis?

Deep vein thrombosis occurs as a result of a blood clot that develops in a vein in the body, most typically in the thigh area or lower leg. A clot can cause huge complications if it breaks away and is transported to the lungs, where it can cause a pulmonary embolism, damaging the artery and surrounding tissue.

Any DVT can be life-threatening if the condition isn’t managed properly.

• A deep vein thrombosis will often exhibit symptoms such as swelling in the affected limb and a feeling of warmth. The area might painful or tender to touch.
• A pulmonary embolism is possible if you then develop symptoms such as difficulty breathing, sudden chest pain and coughing blood.

Why are SCI Patients at Risk of DVT?

Individuals who have sustained a serious spinal cord injury are particularly at risk of developing DVT, especially in the early stages following their injury. In one study, 43% of patients were found to have a DVT within seven days up to three to four weeks following their diagnosis. 

Lack of mobility, due to full or partial paralysis, puts those with SCIs at a higher risk of developing a DVT. This is because the movement of blood through the veins slows down which then increases the likelihood of a clot developing in the first place.

If a person also has other contributing factors, such as being overweight or has a previous history of heart problems, the risk of deep vein thrombosis is also likely to increase. The potential in the early stages of injury is more pronounced because the individual often has to be kept immobile whilst they initially recover from their injury.

Once someone has passed the initial treatment stage of their spinal cord injury, that does not mean the risk of developing a DVT has diminished completely. A lot will depend on the extent and level of their injury. Those with full paralysis below the neck are more likely to have issues with DVTs than someone that has partial damage below the waist.

Whilst the risk of DVT will decrease after the acute stage, research suggests that as many as 12% of patients are still at risk between the third and twelfth month following their injury.

Preventing DVT in SCI Patients

When someone has been diagnosed with a spinal cord injury, there are a lot of things that need to be done in the initial stages of recovery. This includes monitoring the individual to make sure that the risk of secondary issues such as developing deep vein thrombosis are kept to a minimum.

It’s important to try and prevent a problem such as spinal thrombosis from occurring and typically this is managed by administering anticoagulants which help to stop clots from forming. These medications are generally administered within the first few days following a spinal cord injury but may continue to be provided after the initial recovery phase.

An ultrasound process called Duplex is usually employed to diagnose a blood clot. This involves pushing the clot to depress or collapse it using the ultrasound device as well as looking for abnormalities in blood flow.

Treatment will depend on the size and severity of the blood clot and may include hospitalization and the use of a powerful anti-coagulant such as heparin or warfarin. In most cases, the clot will eventually dissolve, though in some cases, the patient may need to continue taking blood thinning for an extended period of time.

Regular monitoring is obviously important for those with a spinal cord injury and recognizing the symptoms associated with various potential secondary complications is vital for maintaining good health. Maintaining movement and blood flow through exercise can also help prevent clots from developing in the first place.