As far as is generally known, major orthopaedic surgery carries a potential risk of venous thromboembolic disease, including venous thrombosis and pulmonary embolism. It is therefore important to take perioperative measures to prevent venous thrombosis and pulmonary embolism in orthopedic surgery. However, there are fewer reports on venous thromboembolism after spine surgery, with the incidence reported in the literature ranging from 0.3% to 31%, and with far fewer monitoring methods than for lower extremity surgery. Guidelines for the prevention of venous thromboembolic disease in spine surgery are lacking to date, and, the American College of Chest Physicians VIII guidelines do not recommend thromboprophylaxis for all patients undergoing spine surgery. To address this situation, scholars from the Department of Orthopaedics, Mie University School of Medicine, Japan, conducted a prospective study to present the incidence and countermeasures for venous thromboembolism in spine surgery, which was published in Spine in May 2014. The prospective case study included 209 cases of spine surgery, 121 of which were male and 88 female (mean age 64 years). All cases underwent preoperative and postoperative vascular ultrasound of both lower extremities to prevent thrombosis with an inflatable compression device and standard compression stockings, without medication. If distal type DVT was detected preoperatively, APTT time was adjusted to 40-50s using heparin (500 U/hour) until discontinued 6 hours before surgery. The results of the study showed that venous thromboembolism occurred perioperatively in 23 patients (11%), of which 9 (4.3%) occurred preoperatively, proximal deep vein thrombosis, asymptomatic pulmonary embolism in 1 case (preoperative placement of an inferior vena cava filter), and distal deep vein thrombosis in 8 cases. 14 (6.7%, Table 3) had new venous thromboembolism after surgery, of which 2 (proximal deep vein thrombosis, pulmonary embolism Ultrasound follow-up revealed complete resolution of distal DVT in 85% (17/20) of the perioperative cases. These results show the importance of using vascular ultrasound to assess deep vein thrombosis in patients undergoing spinal surgery for the proper treatment of venous thromboembolic disease. This is especially true for high-risk cases of advanced age and combined neurological impairment. Prophylaxis with inflatable compression devices and standard compression stockings is effective, whereas in cases of spinal tumors or trauma, the use of chemical agents such as anticoagulants should be considered. It should also be recognized, however, that although this study demonstrates the importance of ultrasound monitoring for thrombotic disease in the perioperative period of spine surgery, it may not be clinically applicable to all cases of spine surgery. Monitoring is recommended in cases of advanced age and in patients with combined underlying cardiovascular disease, such as hypertension, and thrombus monitoring is also recommended in patients with neurological impairment or postoperative pain requiring bed rest.