Abstract
Purpose
This study was designed to reveal the association between spinal parameters and RCS
area in patients with adult spinal deformities treated with spinal correction surgery.
We hypothesized that reduction of the retrocrural space (RCS) area is related to thoracolumbar
alignment, which may cause acute celiac artery compression syndrome (ACACS).
Methods
Eighty-nine patients (age: 68.4 ± 7.6 years; sex: 7 male/82 female) with ASD treated
by spinal correction surgery were enrolled. Preoperative and postoperative spinal
parameters were measured, and the differences between these parameters were calculated.
Postoperative T12 translation was measured and RCS area was evaluated using reconstructed
computed tomography. The change of RCS area after surgery was defined as ΔRCS. Patients
were divided into increased and decreased RCS groups by the ΔRCS value, and spinal
parameters were compared between groups. The correlation between spinal parameters
and ΔRCS was calculated.
Results
The patients in the decreased RCS group had greater anterior T12 translation than
those in the increased RCS group (p < 0.001). T12 translation was significantly correlated
with ΔRCS (β = −0.31, p = 0.017). There were no correlations between ΔRCS and other
spinal parameters.
Conclusion
Thoracolumbar alignment was associated with RCS area. Consistent with the hypothesis,
overcorrection of the thoracolumbar junction was associated with reduced RCS area
and might be one risk factor for ACACS.
Keywords
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References
- Predictors of poor global alignment and proportion score after surgery for adult spinal deformity.Spine. 2019 Oct; 44: E1136-E1143
- Patient satisfaction after adult spinal deformity surgery does not strongly correlate with health-related quality of life scores, radiographic parameters, or occurrence of complications.Spine. 2017 May; 42: 764-769
- Anterior column realignment (ACR) in adult sagittal deformity correction: technique and review of the literature.Spine. 2016 Apr; 41: S66-S73
- International spine study group. Medical complications after adult spinal deformity surgery: incidence, risk factors, and clinical impact.Spine. 2016 Nov; 41: 1718-1723
- First report of major vascular injury due to lateral transpsoas approach leading to fatality.J Neurosurg Spine. 2014 Nov; 21: 794-798
- A case report of a rare complication of bowel perforation in extreme lateral interbody fusion.Eur Spine J. 2015 Apr; 24: 405-408
- Acute celiac artery compression syndrome with superior mesenteric artery stenosis and aortic stenosis: a rare but life-threatening complication after adult spinal deformity surgery.J Orthop Sci. 2023 Aug; 28: 492-494
- Acute celiac artery compression syndrome after surgical correction of Scheuermann kyphosis.Spine. 2009 Feb; 34: E149-E152
- Acute celiac artery compression syndrome after extensive correction of sagittal balance on an adult spinal deformity.Eur Spine J. 2017 May; 26: 31-35
- Celiac artery syndrome after correction of kyphoscoliosis.Spine Deform. 2019 Jan; 7: 176-179
- Temporary liver and stomach necrosis after lateral approach for interbody fusion and deformity correction of lumbar spine: report of two cases and review of the literature.Eur Spine J. 2016 May; 25: 257-266
- Hepatic ischemia as a complication after correction of post-traumatic gibbus at the thoracolumbar junction.Spine. 2000 Apr 15; 25: 1040-1044
- Median arcuate ligament syndrome: evaluation with CT angiography.Radiographics. 2005 Sep; 25: 1177-1182
- Computed tomographic evaluation of the diaphragmatic crura.Radiology. 1978 Feb; 126: 413-416
- Anatomy of the crura of the diaphragm and the surgery of hiatus hernia.Thorax. 1954 Sep; 9: 175-189
- The diaphragmatic crura and retrocrural space: normal imaging appearance, variants, and pathologic conditions.Radiographics. 2008 Sep; 28: 1289-1305
- Computed tomography of retrocrural spaces: normal, anatomic variants, and pathologic conditions.AJR Am J Roentgenol. 1985 Jul; 145: 81-86
- Median arcuate ligament syndrome-review of this rare disease.JAMA Surg. 2016 May 1; 151: 471-477
- Relationship of the celiac trunk with median arcuate ligament of the diaphragm.Int J Morphol. 2006 Jun; 24: 263-274
- Impact of adult spinal deformity corrective surgery in patients with the symptoms of gastroesophageal reflux disease: a 5-year follow-up report.Eur Spine J. 2020 Apr; 29: 860-869
- Surgical conditions of the diaphragm: anatomy and physiology.Thorac Surg Clin. 2009 Nov; 19: 419-429
- Interprofessional management of median arcuate ligament syndrome (dunbar syndrome) related to lumbar lordosis and hip dysplasia: a patient's perspective.Eur J Case Rep Intern Med. 2020 Apr 16; 7001605
- Celiac compression syndrome.Am J Surg. 1968 Jan; 115: 97-102
Article info
Publication history
Published online: March 15, 2023
Accepted:
February 23,
2023
Received in revised form:
February 5,
2023
Received:
November 14,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
