Kroenung Patrick, Zakko Philip, Park Daniel
Department of Orthopaedic Surgery, Corewell Health East Beaumont University Hospital, Royal Oak, USA.
Department of Orthopaedic Surgery, Michigan Orthopaedic Surgeons, Southfield, USA.
Cureus. 2024 Jun 13;16(6):e62314. doi: 10.7759/cureus.62314. eCollection 2024 Jun.
Paraspinal compartment syndrome is a rare and potentially life-threatening condition. Diagnosis and treatment are often delayed due to a broad differential for back pain, from musculoskeletal to abdominal etiologies. Diagnosis is made with difficulty through clinical picture, laboratory values representative of rhabdomyolysis, advanced imaging, and compartment pressure measurements. Unfortunately, this diagnosis is late; therefore, risks of significant morbidity increase. The mainstay of treatment is emergent fasciotomy of the paraspinal muscles and medical management of rhabdomyolysis. The majority of patients return to baseline functional strength and full range of motion after early treatment. We present a case of severe bilateral paraspinal compartment syndrome that resulted in excisional debridement of necrotic muscle, acute kidney injury, and ileus.
椎旁间隙综合征是一种罕见且可能危及生命的疾病。由于背痛的鉴别诊断范围广泛，从肌肉骨骼到腹部病因，其诊断和治疗常常延迟。通过临床表现、代表横纹肌溶解的实验室检查值、高级影像学检查和间隙压力测量来进行诊断存在困难。不幸的是，这种诊断往往较晚；因此，严重发病的风险增加。治疗的主要方法是紧急行椎旁肌筋膜切开术以及对横纹肌溶解进行药物治疗。大多数患者在早期治疗后恢复到基线功能强度和全范围活动。我们报告一例严重双侧椎旁间隙综合征病例，该病例导致坏死肌肉切除清创、急性肾损伤和肠梗阻。
