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European Spine Journal

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01-05-2016 | Case Report

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

Authors: Haris S. Vasiliadis, Regula Teuscher, Mark Kleinschmidt, Susanne Marrè, Paul Heini

Published in: European Spine Journal | Special Issue 1/2016

Abstract

Introduction

Corrections of spinal deformities have been associated with a potential of postoperative vessel-originating complications. Reports of occlusions of celiac artery seem though to be very rare.

Case reports

We present two cases that developed acute arterial supply impairment and subsequent liver and gastric necrosis due to an occlusion of celiac artery, after a spine deformity correction. In both patients a lateral surgical approach to the superior lumbar spine, lateral placement of cages and then a subsequent posterior fixation were performed.

Review

The literature search reveals the report of three similar cases, with potentially different pathogenetic mechanisms and with a different prognosis. This complication is assumed to occur due to a Medial Arcuate Ligament syndrome (MALS) developed postoperatively that leaded to compression of the celiac artery against the Medial Arcuate Ligament. The pathogenesis though remains unclear and two theories are assumed to explain the acute appearance of the syndrome; the alteration of the anatomic relationship between the vessels and the surrounding tissues due to the spine deformity correction and an intraoperative direct or indirect traction injury of the celiac trunk that caused or increased its pressure against the medial arcuate ligament.

Conclusion

The spine surgeon should be aware of the possibility of postoperative ischemia of the liver and stomach by occlusion of the celiac artery or its supplying branches. Specifically when a large correction of a kyphotic/kyphoscoliotic spine is planed, the surgeon should be alert for an appearance of a MALS.

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Title: 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
Authors: Haris S. Vasiliadis
Regula Teuscher
Mark Kleinschmidt
Susanne Marrè
Paul Heini
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue Special Issue 1/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-016-4562-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Introduction

Case reports

Review

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Case reports

Review

Conclusion

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