Median Arcuate Ligament and Origin of the Celiac Artery Proximity Change in Patients after Surgery to Correct Adult Spinal Deformity: Potential Risk Factors for Acute Celiac Artery Compression Syndrome

Shuhei Ohyama; Toshiaki Kotani; Yasushi Iijima; Takahiro Sunami; Shun Okuwaki; Tsuyoshi Sakuma; Yosuke Ogata; Shuhei Iwata; Tsutomu Akazawa; Kazuhide Inage; Yasuhiro Shiga; Shohei Minami; Seiji Ohtori

doi:10.22603/ssrr.2023-0051

Median Arcuate Ligament and Origin of the Celiac Artery Proximity Change in Patients after Surgery to Correct Adult Spinal Deformity: Potential Risk Factors for Acute Celiac Artery Compression Syndrome

Spine Surg Relat Res. 2023 Jun 9;7(6):512-518. doi: 10.22603/ssrr.2023-0051. eCollection 2023 Nov 27.

Authors

Affiliations

¹ Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
² Department of Orthopedic Surgery, University of Tsukuba, Tsukuba, Japan.
³ Department of Orthopedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
⁴ Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

Abstract

Introduction: This study aimed to determine whether the proximity of the median arcuate ligament (MAL) and the celiac artery (CA) changes in patients following surgery to correct adult spinal deformity (ASD). We hypothesized that the distance between the MAL and the CA shortens after corrective spinal surgery, which may cause acute celiac artery compression syndrome (ACACS).

Methods: A total of 89 patients (68.4±7.6 years; 7 men/82 women) with ASD treated with spinal correction surgery were included in the present retrospective study. The level of the MAL, CA, and distance between the MAL and the CA (DMC) were determined via reconstructed computed tomography. MAL overlap was determined preoperatively and postoperatively.

Results: The MAL and CA moved caudally following surgery. On average, after surgery, no changes in DMC were observed. We found preoperative MAL overlap in 32 (36%) patients, who also had postoperative MAL overlap. No patients showed any MAL overlap postoperatively.

Conclusions: Contrary to our hypothesis, the distance between the MAL and the CA did not shorten, and emerging MAL overlap was not observed postoperatively.

Keywords: Median arcuate ligament; acute celiac artery compression syndrome; adult spinal deformity; celiac artery; risk factor.