Sancineto Carlos, Godoy Monzon Daniel
Trauma Unit, Orthopedic and Traumatology Service, Italian Hospital, Buenos Aires, Argentina.
J Spinal Disord Tech. 2004 Aug;17(4):336-8. doi: 10.1097/01.bsd.0000097252.54459.ef.
Compartment syndrome of the thigh is an uncommon pathology, and its acute presentation after spinal surgery is rare. Because a large muscle mass is involved and systemic manifestations of crush syndrome and altered mental status are present, such abnormalities may lead to a delay in appropriate diagnosis and subsequent treatment. A 56-year-old man who was suspected of having a posterior compartment syndrome in the thigh after spinal decompression in the knee-chest position was evaluated clinically and with the use of a catheter for intracompartmental pressure measurement as a tool to help establish the diagnosis and monitor the evolution. Because of sciatic involvement and a demonstrated increase in the pressure in the posterior compartment with myoglobinuria and acute renal failure, prompt longitudinal fasciotomy was performed with excellent neurologic recovery and improvement of both clinical parameters and mental status.
大腿骨筋膜室综合征是一种罕见的病症，其在脊柱手术后急性发作的情况更为罕见。由于受累肌肉量较大且存在挤压综合征的全身表现以及精神状态改变，这些异常情况可能导致诊断及后续治疗的延误。一名56岁男性在膝胸位脊柱减压术后疑似发生大腿后骨筋膜室综合征，我们对其进行了临床评估，并使用导管测量骨筋膜室内压力作为辅助诊断和监测病情进展的工具。由于坐骨神经受累且后骨筋膜室内压力升高，同时伴有肌红蛋白尿和急性肾衰竭，遂立即进行了纵行筋膜切开术，术后神经功能恢复良好，临床指标和精神状态均有所改善。
