From July 1997 to October 2003, 640 patients with adolescent scoliosis who had undergone surgical treatment were evaluated prospectively, 7 patients of whom suffered from SMAS post-operatively. The height of the 7 patients who developed SMAS was above the mean of sex- and age-matched normal population, with the height percentile ranging from 5% to 50%. On the contrary, their weight was below the mean of the normal population with a weight percentile ranging from 5% to 25%. Among the 7 patients, 4 had a thoracic hyperkyphosis ranging from 55° to 88° (average 72°) and 2 had a thoracolumbar kyphosis of 25° and 32° respectively. The 7 patients were all treated with fasting, antiemetic medication and intravenous fluids, a nasogastric tube was passed and aspirations commenced. Reduction or suspense of traction was adopted in three patients who had SMAS during Halo-femoral traction after anterior release of scoliosis. All the patients recovered completely with no sequelae.