Could a 30-Day blood thinner regimen prevent clots after spine cancer surgery?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Age 18 years or older * Undergone spinal surgery (any approach) for treatment of vertebral metastatic disease at UPMC Presbyterian, Shadyside, or Mercy Hospital * Planned for discharge to home or acute rehabilitation facility (not hospice) * Willing and able to provide written informed consent * Able to take oral medications * Access to a telephone for follow-up calls Exclusion Criteria: * Already receiving therapeutic anticoagulation for another indication (e.g., atrial fibrillation, prior VTE, mechanical heart valve) * Planned initiation of therapeutic anticoagulation within the next 30 days for another indication * Known allergy or hypersensitivity to apixaban * History of pathological bleeding (e.g., intracranial hemorrhage, gastrointestinal bleeding requiring transfusion or endoscopic intervention within the past 6 months) * Active bleeding at time of planned enrollment * Platelet count less than 50,000/mm³ at time of enrollment * Hemoglobin less than 8 g/dL at time of enrollment * Serum creatinine greater than 2.5 mg/dL * ALT or AST greater than 3 times the upper limit of normal * Total bilirubin greater than 2 times the upper limit of normal * Known severe hepatic impairment (Child-Pugh Class C) * Pregnancy or breastfeeding * Women of childbearing potential unwilling to use adequate contraception during study participation * History of proximal gastrointestinal resection (i.e., gastrectomy and/or proximal small bowel resection) that might alter oral drug absorption * Concurrent use of strong dual inhibitors of CYP3A4 and P-gp or moderate CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir, clarithromycin, diltiazem) * Concurrent use of strong dual inducers of CYP3A4 and P-gp (rifampin, carbamazepine, phenytoin, St. John's Wort) * Inability to safely discontinue all antiplatelet medications for the 30-day study drug period, as determined by the treating cardiologist or prescribing physician (aspirin, clopidogrel, ticagrelor) * Inability or unwillingness to discontinue chronic NSAID use during the 30-day study drug period (as-needed use less than 3 days per week is acceptable) * Planned surgery or invasive procedure within the next 30 days * Hospital length of stay 30 days or greater * Prisoner or incarcerated individual * Any other condition that, in the investigator's opinion, would make the subject unsuitable for study participation or unable to comply with study procedures