Cohen Children's Medical Center of New York, New Hyde Park, New York, USA.
Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers, The State University of New Jersey, Newark, New Jersey, USA.
Spine Deform. 2024 Nov;12(6):1529-1543. doi: 10.1007/s43390-024-00929-5. Epub 2024 Jul 24.
Superior mesenteric artery (SMA) syndrome is the compression of the third portion of the duodenum between the abdominal aorta and the superior mesenteric artery. Although multifactorial, the most frequent cause of SMA syndrome is significant weight loss and cachexia often induced by catabolic stress. SMA syndrome resulting from scoliosis surgery is caused by a reduction of the aortomesenteric angle and distance. Risk factors include rapid weight loss, malnutrition, and a rapid reduction in the mesenteric fat pad and are the most common causes of a decrease in the aortomesenteric angle and distance. Surgically lengthening the vertebral column can also lead to a reduction of the aortomesenteric distance, therefore, has been identified as a risk factor unique to spinal surgery. Despite a reported decline in SMA syndrome cases due to improved surgical techniques, duodenal compression is still a risk and remains a life-threatening complication of scoliosis surgery. This article is a cumulative review of the evidence of being underweight or having a low body mass index as risk factors for developing SMA syndrome following surgical scoliosis instrumentation and correction.
肠系膜上动脉（SMA）综合征是指十二指肠第三部分在腹主动脉和肠系膜上动脉之间受压。尽管多因素，但 SMA 综合征最常见的原因是由分解代谢应激引起的显著体重减轻和恶病质。由脊柱侧凸手术引起的 SMA 综合征是由于主动脉肠系膜角和距离减小引起的。危险因素包括体重迅速下降、营养不良和肠系膜脂肪垫迅速减少，是导致主动脉肠系膜角度和距离减小的最常见原因。手术延长脊柱也会导致主动脉肠系膜距离减小，因此被确定为脊柱手术特有的危险因素。尽管由于手术技术的改进，报道的 SMA 综合征病例有所减少，但十二指肠受压仍然是一种风险，并且仍然是脊柱侧凸手术的危及生命的并发症。本文是对体重过轻或体重指数低作为手术矫正脊柱侧凸后发生 SMA 综合征的危险因素的证据的累积回顾。
