Department of Orthopedic Surgery, Philadelphia College of Osteopathic Medicine, 4190 City Ave, Suite 409, Philadelphia, PA, 19131, USA.
Department of Medicine, Philadelphia College of Osteopathic Medicine, 4190 City Ave, Suite 100, Philadelphia, PA, 19131, USA.
J Orthop Surg Res. 2024 Jun 23;19(1):372. doi: 10.1186/s13018-024-04860-3.
Compartment syndrome is a well-known phenomenon that is most commonly reported in the extremities. However, paralumbar compartment syndrome is rarely described in available literature. The authors present a case of paralumbar compartment syndrome after high intensity deadlifting.
53-year-old male who presented with progressively worsening low back pain and paresthesias one day after high-intensity deadlifting. Laboratory testing found the patient to be in rhabdomyolysis; he was admitted for intravenous fluid resuscitation and pain control. Orthopedics was consulted, and Magnetic Resonance Imaging revealed significant paravertebral edema and loss of muscle striation. Given the patient's lack of improvement with intravenous and oral pain control, clinical and radiographic findings, there was significant concern for acute paralumbar compartment syndrome. The patient subsequently underwent urgent fasciotomy of bilateral paralumbar musculature with delayed closure.
Given the paucity of literature on paralumbar compartment syndrome, the authors' goal is to promote awareness of the diagnosis, as it should be included in the differential diagnosis of intractable back pain after high exertional exercise. The current literature suggests that operative cases of paralumbar compartment syndromes have a higher rate of return to pre-operative function compared to those treated non-operatively. This case report further supports this notion. The authors recommend further study into this phenomenon, given its potential to result in persistent chronic exertional pain and irreversible tissue damage.
腔室综合征是一种众所周知的现象,最常发生在四肢。然而,在现有文献中很少有关于腰部腔室综合征的描述。作者报告了一例高强度硬拉后腰部腔室综合征的病例。
一位 53 岁男性,在高强度硬拉后一天出现逐渐加重的腰痛和感觉异常。实验室检查发现患者横纹肌溶解症;他被收治入院进行静脉补液和止痛治疗。骨科会诊,磁共振成像显示明显的椎旁水肿和肌肉条纹消失。鉴于患者静脉和口服止痛治疗无改善,临床表现和影像学发现,高度怀疑急性腰部腔室综合征。随后对双侧腰部肌肉进行紧急筋膜切开术,并延迟缝合。
鉴于腰部腔室综合征文献较少,作者的目的是提高对该疾病的诊断意识,因为它应被纳入高强度运动后顽固性腰痛的鉴别诊断。目前的文献表明,与非手术治疗相比,手术治疗的腰部腔室综合征病例恢复术前功能的比例更高。本病例报告进一步支持了这一观点。鉴于其可能导致持续性慢性运动性疼痛和不可逆转的组织损伤,作者建议对此现象进行进一步研究。