Abol Oyoun Nariman, Kadhim Muayad, Dormans John P
Department of Orthopaedic Surgery, Assiut University Hospital Assiut 71526 Egypt ; Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia 3401 Civic Center Boulevard Philadelphia PA 19104 USA.
Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia 3401 Civic Center Boulevard Philadelphia PA 19104 USA.
SICOT J. 2015 Jun 15;1:12. doi: 10.1051/sicotj/2015010.
Superior mesenteric artery (SMA) syndrome has been reported as an uncommon condition of external vascular compression of the SMA particularly after rapid weight loss, body casts, or after corrective surgery for spinal deformities, usually within the first few weeks after surgery.
This is a retrospective report of a case of a non-verbal autistic female patient who started to develop SMA syndrome at the age of 16, 4 years after posterior spinal fusion surgery for scoliosis. She was treated conservatively by increasing oral caloric intake, which resulted in increased body weight and relief of symptoms.
Seen at 10 years' follow up, the patient is doing well, and is functional within the limits of her suboptimal cognitive and verbal conditions. She maintains good trunk balance with solid spinal fusion and intact instrumentation at latest follow up.
Spinal surgeons should maintain a high index of suspicion for diagnosis of SMA syndrome even years after scoliosis surgery, especially for patients with communication problems, like the case we present here. Appropriate conservative measures can succeed in relieving the symptoms, increasing body weight, and preventing complications including the risk of death.
肠系膜上动脉(SMA)综合征被报道为一种不常见的SMA外部血管受压情况,尤其在快速减重、使用身体石膏固定后,或脊柱畸形矫正手术后,通常在术后几周内出现。
这是一份关于一名非言语型自闭症女性患者的回顾性病例报告。该患者在16岁时,即脊柱侧弯后路融合手术后4年,开始出现SMA综合征。通过增加口服热量摄入进行保守治疗,体重增加,症状缓解。
随访10年时,患者情况良好,在其认知和言语功能欠佳的情况下能正常生活。最新随访时,脊柱融合稳固、内固定完好,她保持着良好的躯干平衡。
脊柱外科医生即使在脊柱侧弯手术后数年,对SMA综合征的诊断也应保持高度怀疑,尤其是对于像我们这里所呈现病例的有沟通问题的患者。适当的保守措施能够成功缓解症状、增加体重并预防包括死亡风险在内的并发症。