Weight-based, anti-Xa guided enoxaparin after spine trauma surgery: target attainment and safety in a retrospective cohort

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Patients undergoing surgery for traumatic spine injuries have a high risk of venous thromboembolism (VTE), with rates reported between 8% to 10%.
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A retrospective cohort study evaluated anti-Xa-guided enoxaparin dosing in postoperative spine trauma patients to assess target attainment and safety outcomes.
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Symptomatic VTE rates were similar between the anti-Xa cohort and the fixed dose cohort, at 1.1% and 1.6%, respectively.
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In the anti-Xa cohort, 28% of patients required dose escalation, and no postoperative epidural hematomas were reported.
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The study found that anti-Xa-guided dosing did not increase bleeding requiring transfusion compared to fixed dosing.

Frontiers In Surgery

by Dallas L. Sheinberg, David Travis Johnston, Brendan T. O'Reilly, Gabriel Galan Castro, Jawad R. Khazaal, Joseph S. Withrow, Duncan J. Trimble, Ankush Chandra, Anthony J. Lim, Derek S. Sheinberg, Jennifer Zaragoza, Wen Li, John R. Williams
June 24, 2026

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