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运动后椎旁间隔综合征:一例报告

Paravertebral compartment syndrome after exercise: a case report.

作者信息

Ogoshi Tomofumi, Yoshimiya Motoo, Ichibakase Hiroshi, Kimura Takayoshi, Kameoka Masafumi, Yoshioka Hayato, Ueda Takahiro, Homma Masato, Enokida Shinpei

机构信息

Department of Emergency and Critical Medicine, Tottori University Hospital, 36-1, Nishichou, Yonago, Tottori, Japan.

Department of Orthopedics, Tottori University Hospital, 36-1, Nishichou, Yonago, Tottori, Japan.

出版信息

J Med Case Rep. 2020 Nov 1;14(1):208. doi: 10.1186/s13256-020-02535-1.

Abstract

BACKGROUND

Paravertebral compartment syndrome occurring without trauma is quite rare. We report a case of compartment syndrome that occurred after spinal exercises.

CASE PRESENTATION

A 23-year-old Japanese rower developed severe back pain and was unable to move 1 day after performing exercises for the spinal muscles. Initial evaluation at a nearby hospital revealed hematuria and elevated creatine phosphokinase levels. He was transferred to our hospital, where magnetic resonance imaging revealed no hematoma but confirmed edema in the paravertebral muscles. The compartment pressure measurements were elevated bilaterally. Despite his pain being severe, his creatine phosphokinase levels were expected to peak and decline; his urine output was normal; and surgery was undesirable. Therefore, we opted for conservative management. The next day, the patient's compartment pressure diminished, and his pain levels decreased to 2/10. After 5 days, he was able to walk without medication.

CONCLUSIONS

We present a rare case of compartment syndrome of the paravertebral muscles with good resolution following conservative management. We hope our case findings will help avoid unnecessary surgery in cases of paravertebral compartment syndrome.

摘要

背景

无创伤情况下发生的椎旁间隔综合征非常罕见。我们报告一例脊柱锻炼后发生的间隔综合征病例。

病例介绍

一名23岁的日本赛艇运动员在进行脊柱肌肉锻炼1天后出现严重背痛且无法活动。附近医院的初步评估显示有血尿和肌酸磷酸激酶水平升高。他被转至我院,磁共振成像未显示血肿,但证实椎旁肌肉有水肿。双侧间隔压力测量值升高。尽管他疼痛剧烈,但预计其肌酸磷酸激酶水平会达到峰值并下降;他的尿量正常;且手术并非首选。因此,我们选择保守治疗。第二天,患者的间隔压力降低,疼痛程度降至十分制的2分。5天后,他无需服药就能行走。

结论

我们报告了一例罕见的椎旁肌肉间隔综合征病例,经保守治疗后恢复良好。我们希望我们的病例发现有助于避免在椎旁间隔综合征病例中进行不必要的手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ae/7603721/c7dbe806fbaf/13256_2020_2535_Fig1_HTML.jpg

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