Critical Clarification: Question Appears to Contain an Error
The question asks about timing of "TAHBSO" after spinal decompression, but TAHBSO (Total Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy) is a gynecologic procedure that has no established relationship to spinal decompression surgery. The provided evidence exclusively addresses spinal cord injury management, thromboprophylaxis timing, and surgical decompression timing—none of which relate to gynecologic surgery.
If the Question Intended to Ask About Thromboprophylaxis After Spinal Decompression:
Pharmacologic thromboprophylaxis should be initiated within 48 hours after spinal decompression surgery to reduce deep vein thrombosis risk without increasing bleeding complications. 1
Timing Recommendations Based on Injury Type:
For spinal cord injury with operative intervention:
- Start chemical prophylaxis within 48 hours postoperatively 1
- Earlier initiation (within 48 hours) reduces DVT rates from 10.8% to 2.1% compared to delayed initiation 1
- No increased risk of bleeding, transfusion requirements, or need for additional decompressive procedures with early initiation 1
For delayed surgery in spinal cord injury cases:
- Begin pharmacologic thromboprophylaxis preoperatively as soon as possible while awaiting surgery 2
- Continue for 3 months duration in patients with motor deficits 3, 2
Specific Clinical Scenarios:
Cervical spine injuries WITH spinal cord injury:
- Postoperative pharmacologic prophylaxis is mandatory 2
- Combine mechanical methods (compression devices) with heparin 3
Cervical spine injuries WITHOUT spinal cord injury:
- Postoperative pharmacologic prophylaxis is not needed 2
Thoracolumbar procedures (anterior or posterior) with or without SCI:
- Postoperative pharmacologic prophylaxis is recommended 2
Critical Pitfall to Avoid:
- Delaying thromboprophylaxis beyond 48 hours postoperatively significantly increases DVT risk (10.8% vs 2.1%) without any safety benefit 1