Acute celiac artery compression syndrome after extensive correction of sagittal balance on an adult spinal deformity

Abstract

ACACS is a life-threatening complication, and therefore, it is very important that ACACS is diagnosed and treated early. Spinal deformity surgeons should be aware of the possible occurrence of this condition after extensive correction of sagittal balance on adult spinal deformity.

The Association Between Corrective Surgery for Adult Spinal Deformity and Serum Levels of Hepatobiliary Enzymes

“…The development of ACACS was assumed to produce a substantial correction force, which shifted the origin of the CA upward and caused the vertebra to push the aorta forward, resulting in the CA being kinked by the MAL. In addition to the ACACS, both the superior mesenteric artery (SMA) and the aorta were simultaneously stenosed (Figures 2A , 2C ) [ 4 , 7 , 15 - 17 ].…”

Median Arcuate Ligament Resection before Surgery for Adult Spinal Deformity in Patient with Preoperative Stenosis of Celiac Artery: A Case Report

“…In the gastrointestinal field, the chronic compression of the CA by the MAL is known as MAL compression syndrome, but the syndrome is rare 7) . Similar to the mechanism of MAL compression syndrome, excessive kyphosis correction also causes acute compression of the CA, leading to multiple organ failure in ACACS [1][2][3]5,6) . Moreover, because of the preoperative stenosis of the CA, we were concerned that this patient was at considerably more risk of developing ACACS 1,3) .…”

“…Similar to the mechanism of MAL compression syndrome, excessive kyphosis correction also causes acute compression of the CA, leading to multiple organ failure in ACACS [1][2][3]5,6) . Moreover, because of the preoperative stenosis of the CA, we were concerned that this patient was at considerably more risk of developing ACACS 1,3) . We considered it would be better to perform MAL resection before spine surgery to avoid ACACS.…”

“…Acute celiac artery compression syndrome (ACACS) after surgery for spinal deformity is a rare but severe complication with potentially fatal consequences [1][2][3][4][5][6] . We report a case in which median arcuate ligament (MAL) resection was performed before spinal surgery for preoperative celiac artery (CA) compression.…”

“…Of the reported cases of ACACS, some have had severe outcomes, including death 1,2,4) , while for two cases in which MAL resection was performed within a few days after spinal surgery, there were good postoperative outcomes 3,6) . Thus, early MAL resection after the onset of ACACS is an effective treatment.…”