Roe John C, Chen Foster, Cho Woojin
Department of Orthopaedic Surgery, Montefiore Medical Center (Dr. Roe, Dr. Chen, and Dr. Cho), and Albert Einstein College of Medicine, Bronx, NY (Dr. Cho).
J Am Acad Orthop Surg Glob Res Rev. 2018 Apr 12;2(4):e063. doi: 10.5435/JAAOSGlobal-D-17-00063. eCollection 2018 Apr.
To report on a patient with acute paravertebral and posterior thigh compartment syndrome after vigorous exercise.
Paravertebral compartment syndrome (PCS) is a rare clinical entity, typically occurring in male athletes after heavy exertion and weightlifting.
A 25-year-old man presented with back pain and hematuria hours after back-specific weightlifting. Clinical examination, laboratory markers, MRI, and elevated intracompartmental pressure measurements supported the diagnosis of bilateral paravertebral and posterior thigh compartment syndrome. The patient underwent paravertebral decompression via the Wiltse approach with immediate postoperative relief. He is doing well at 1 year, with recovery of lumbar extension strength, although MRI demonstrates moderate fatty replacement of paravertebral musculature.
Although rare, early recognition of PCS and timely decompression can limit myonecrosis. Paravertebral compartment syndrome should be considered in the differential for athletic individuals with acute onset back pain.
A case report and review of literature.
报告一例剧烈运动后发生急性椎旁和大腿后骨筋膜室综合征的患者。
椎旁骨筋膜室综合征（PCS）是一种罕见的临床病症，通常发生在男性运动员进行剧烈运动和举重之后。
一名25岁男性在进行特定背部举重运动数小时后出现背痛和血尿。临床检查、实验室指标、磁共振成像（MRI）以及骨筋膜室内压力升高的测量结果均支持双侧椎旁和大腿后骨筋膜室综合征的诊断。患者通过Wiltse入路接受了椎旁减压术，术后疼痛立即缓解。患者在1年时情况良好，腰椎伸展力量恢复，尽管MRI显示椎旁肌肉组织有中度脂肪替代。
尽管罕见，但早期识别PCS并及时减压可限制肌肉坏死。对于急性发作背痛的运动员个体，鉴别诊断时应考虑椎旁骨筋膜室综合征。
病例报告及文献综述。
