Journal List > J Korean Soc Spine Surg > v.25(Suppl 1) > 1125266

Ha, Lee, Cho, and Kim: Acute Lumbar Paraspinal Compartment Syndrome after Weightlifting - A Case Report -

Abstract

Study Design

Case report.

Objectives

To report 2 cases of acute lumbar paraspinal compartment syndrome due to weightlifting.

Summary of Literature Review

Acute lumbar paraspinal compartment syndrome is very rare, but it causes muscle necrosis and acute renal failure. Therefore, it should be treated immediately.

Materials and Methods

A 31-year-old male patient and a 30-year-old male patient visited the emergency room due to severe back pain. The left paraspinal compartment pressure of the 31-year-old patient was measured as 35 mm Hg using the Whitesides technique. The paraspinal compartment pressure of the 30-year-old patient was measured as 22 mm Hg on the left side and 30 mm Hg on the right side. We diagnosed acute lumbar paraspinal compartment syndrome and performed a fasciotomy. This study received Institutional Review Board approval (ID: SC18ZESE0032).

Results

Lab findings improved after fasciotomy. The operative wounds healed after fasciocutaneous flap placement.

Conclusions

Acute lumbar paraspinal compartment syndrome is very rare, but should be considered in patients with severe back pain.

REFERENCES

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2. Whitesides TE, Heckman MM. Acute compartment syndrome. Update on diagnosis and treatment. J Am Acad Orthop Surg. 1996 Jul; 4(4):209–18. DOI: 10.5435/00124635-199607000-00005.
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Fig. 1.
Lumbar X-ray. (A) Lumbar anteroposterior X-ray not showing ileus. (B) Lumbar lateral X-ray showing loss of lumbar lordosis.
jkss-25-133f1.tif
Fig. 2.
Lumbar magnetic resonance imaging. (A) T2-weighted coronal magnetic resonance imaging showing high signal intensity at the left multifidus muscle and the longissimus muscle (arrow). (B) T2-weighted axial magnetic resonance imaging showing high signal intensity at the left erector spinae muscle (arrow).
jkss-25-133f2.tif
Fig. 3.
Lumbar X-ray. (A) Lumbar anteroposterior X-ray not showing ileus. (B) Lumbar lateral X-ray showing loss of lumbar lordosis.
jkss-25-133f3.tif
Fig. 4.
Lumbar magnetic resonance imaging. (A) T2-weighted coronal magnetic resonance imaging showing bilateral high signal intensity and edema at the multifidus, longissimus, iliocostalis lumborum, and quadratus lumborum muscles (arrows). (B) T2-weighted axial magnetic resonance imaging showing bilateral high signal intensity at the erector spinae muscles (arrows).
jkss-25-133f4.tif
Fig. 5.
Intraoperative clinical photo of case 2. (A) The color of the erector spinae had changed in several areas. (B) The color of the erector spinae had changed to gray.
jkss-25-133f5.tif
Fig. 6.
Creatine phosphokinase levels over time.
jkss-25-133f6.tif
Table 1.
Changes in lab findings over time of case 1 and case 2
    Pre-operative(ER) Operation Post-operative 2 days Post-operative 4 days Post-operative 1 week Post-operative 2 weeks Post-operative 4 weeks (case 1) 3 weeks (case 2)
creatinine phosphokinase (U/L) Case 1 46020 58440 26830 10035 1200 164 534
  Case 2 67200 98000 27100 4010 792 211 93
lactate dehydrogenase (IU/L) Case 1 3909 4536 2202 855 497 464 372
  Case 2 3048 3930 1094 591 343 315 289
aspartate aminotransferase (U/L) Case 1 278 615 403 331 51 35 35
  Case 2 316 1084 464 166 41 23 23
alanine aminotransferase (U/L) Case 1 72 216 184 203 93 60 38
  Case 2 66 250 197 146 82 40 39
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