• Shuhei Ohyama, Toshiaki Kotani, Yasushi Iijima, Shun Okuwaki, Takahiro Sunami, Shuhei Iwata, Tsuyoshi Sakuma, Yosuke Ogata, Tsutomu Akazawa, Kazuhide Inage, Yasuhiro Shiga, Shohei Minami, and Seiji Ohtori.
• Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan. Electronic address: oyama.shuhei@gmail.com.
• World Neurosurg. 2023 Dec 1; 180: e591e598e591-e598.

ObjectiveThis study aimed to determine the incidence and potential risk factors of superior mesenteric artery syndrome (SMAS) after corrective spinal surgery in patients with adult spinal deformity (ASD).MethodsIn total, 102 patients (67.6 ± 8.4 years; 8 male/94 female; body mass index (BMI); 22.4 ± 3.6 kg/m2) with ASD treated by spinal correction surgery were enrolled. Preoperative and postoperative spinal parameters, including thoracolumbar kyphosis (TLK: T10-L2) and upper lumbar lordosis (ULL: L1-L4) were measured. To evaluate the potential risk factors of SMAS, the angle and the distance between the superior mesenteric artery and aorta, the aortomesenteric angle (AMA) and aortomesenteric distance (AMD), were evaluated pre- and postoperatively. Based on the postoperative AMA, AMD, and abdominal symptoms, the patients were diagnosed with SMAS. Correlations between demographic data or spinal parameters and AMA and AMD were assessed.ResultsTwo (2.0%) patients were diagnosed with SMAS. Postoperative TLK significantly correlated with postoperative AMA (P = 0.013, 0.046). Postoperative ULL was significantly correlated with postoperative AMD (β = -0.27; P = 0.014).ConclusionThe incidence of SMAS after corrective spinal surgery in patients with ASD was 2.0%. Postoperative smaller TLK and greater ULL can be risk factors for developing SMAS. Spine surgeons should avoid overcorrection of the upper lumbar spine in the sagittal plane to prevent SMAS.Copyright © 2023 Elsevier Inc. All rights reserved.

25 keywords...

hide…