Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
World Neurosurg. 2012 Nov;78(5):553.e5-8. doi: 10.1016/j.wneu.2012.03.027. Epub 2012 Apr 3.
Acute compartment syndrome (ACS) after posterior spinal surgery is very uncommon. Most of the reported cases have ACS in the legs related to positioning in the knee-chest position; postoperative ACS in the thighs is exceedingly rare, with only one reported case (17).
This study reports two patients who had local muscle necrosis/ACS after spine surgery in the prone position and discusses preventive measures. Both of our complications were probably related to reversing the position of the iliac crest and hip pads on a Jackson operating table, which was done to achieve better lumbar lordosis.
Our cases indicate the need for a high index of suspicion of ACS in patients who have persistent unresolved pain and local swelling. Tissue pressure monitoring is an option in suspected cases. Iliac crest and thigh pads should not be reversed during positioning on a Jackson table.
后路脊柱手术后发生急性骨筋膜室综合征（ACS）非常少见。大多数报道的病例均为膝关节-胸部体位下腿部与定位相关的 ACS；术后大腿部 ACS 极为罕见，仅有 1 例报道（17）。
本研究报告了 2 例后路脊柱手术患者在俯卧位后发生局部肌肉坏死/ACS，并讨论了预防措施。我们的并发症可能都与在 Jackson 手术台上反向放置髂嵴和髋垫有关，这样做是为了获得更好的腰椎前凸。
我们的病例表明，对于持续存在无法解释的疼痛和局部肿胀的患者，需要高度怀疑 ACS。在疑似病例中，可以选择监测组织压力。在 Jackson 手术台上定位时，不应反向放置髂嵴和大腿垫。
