I'm more than a little nervous. After having a total hip replacement, I ended up with a blood clot in my leg. I know these things can go to the lungs and kill you. Now I'm going to have an operation to fuse my spine. Will I get a blood clot every time I have surgery?

Doctors want to predict and prevent blood clots after surgery. Knowing a patient's risk factors is the first step in that process. Having a previous blood clot puts you at increased risk, but it doesn't guarantee another blood clot. Make sure your spine surgeon knows about your previous history.

Scientists think the risk of blood clots is greater after surgery to the legs compared with surgery to the spine. But the statistics aren't all in for spine surgery yet, so this is a little unclear. Other risk factors include being overweight, a long period of immobility or bedrest, and heart problems.

For a long time, doctors thought drugs to thin the blood and prevent blood clots from forming was the best way to go. More recent studies have called this into question. The problem of bleeding too much from taking blood thinners during spine surgery concerns doctors, too.

Until more is known about this issue, keep the lines of communication open with your doctor. Tell him or her your concerns and find out what steps will be taken to prevent and treat blood clots.