Abdominal complications following kyphosis correction in ankylosing spondylitis

Spinal deformity surgery is associated with high rates of morbidity and a wide range of complications. The most significant abdominal complications following kyphosis correction, while uncommon, can certainly pose significant infectious and hemodynamic risks to the patient. Abdominal compartment syndrome is the most severe of the sequelae. It is the end result of elevated abdominal compartment pressure with physiological compromise and end organ system dysfunction. Although most commonly associated with trauma, abdominal compartment syndrome has also been witnessed following massive fluid shifts, which can occur during adult spinal deformity surgery. In this manuscript, we report on 2 patients with ankylosing spondylitis who developed significant abdominal pathology requiring exploratory laparotomy following kyphosis correction. In addition to describing the details of each case, we propose explanations of the relevant pathophysiology and review diagnostic and treatment strategies for such events. The key to effectively treating such a debilitating complication is to recognize it quickly and intervene rapidly and aggressively.