Acute lumbar paraspinal compartment syndrome: a case report and detailed literature review

Ahlam M. Alfaraj; Zainab M. Alfaraj; Abdullah G. Alsahwan

doi:10.18203/2349-2902.isj20164699

Authors

Ahlam M. Alfaraj General Physician, Department of Surgery, Baystate Medical Center, Springfield, Massachusetts, USA
Zainab M. Alfaraj MBBS, Medical Intern, University of Dammam, Collage of Medicine, Dammam, KSA
Abdullah G. Alsahwan MBBS, Medical Intern, University of Dammam, Collage of Medicine, Dammam, KSA

DOI:

https://doi.org/10.18203/2349-2902.isj20164699

Keywords:

Compartment syndrome, Creatine kinase, Fasciotomy, Lumbar paraspinal compartment syndrome, Rhabdomyolysis

Abstract

The 17th case of acute lumbar paraspinal compartment syndrome in the scientific/medical literature was presented in this study. We then review all 17 cases for demographic and clinical characteristics, in particular in terms of how they influence ultimate outcomes. All but one case occurred in a male, and most patients were less than age 40 (71%). Symptoms typically were precipitated by some athletic activity (59%), other causes were surgery (n = 4), drug abuse (n = 2), and direct trauma (n =1). Peak CPK values ranged from 5000 to 350,000 U/L. Ten patients ultimately achieved or were presumed to achieve full recovery, six had persistent low back pain several months later and one remained in renal failure. The only predictor of final outcome was the treatment given, with six of seven who underwent surgical fasciotomy and both patients administered hyperbaric oxygen experiencing full recovery, versus just two of seven treated conservatively (p = 0.03).

Metrics

Metrics Loading ...

References

Nathan ST, Roberts CS, Deliberato D. Lumbar paraspinal compartment syndrome. Int Orthop. 2012;36(6):1221-7.

Allerton C, Gawthrope IC. Acute paraspinal compartment syndrome as an unusual cause of severe low back pain. Emerg Med Australas. 2012;24(4):457-9.

Calvert N, Bhalla T, Twerenbold R. Acute exertional paraspinal compartment syndrome. ANZ J Surg. 2012;82(7):564-5.

Karam MD, Amendola A, Lattes MS. Case report: successful treatment of acute exertional paraspinal compartment syndrome with hyperbaric oxygen therapy. Iowa Orthop J. 2010;30:188-90.

Levine M, Levitan R, Skolnik A. Compartment syndrome after "bath salts" use: a case series. Ann Emerg Med. 2013;61(4):480-483.

Paryavi E, Jobin CM, Ludwig SC, Zahiri H, Cushman J. Acute exertional lumbar paraspinal compartment syndrome. Spine. 2010;35(25):1529-33.

Minnema BJ, Neligan PC, Quraishi NA, Fehlings MG, Prakash S. A case of occult compartment syndrome and nonresolving rhabdomyolysis. J Gen Intern Med. 2008;23(6):871-4.

Haig AJ, Hartigan AG, Quint D. Low back pain after nonspinal surgery: the characteristics of presumed lumbar paraspinal compartment syndrome. PMR. 2009;1(4):383-8.

Khan RJ, Fick DP, Guier CA, Menolascino MJ, Neal MC. Acute paraspinal compartment syndrome. A case report. J Bone Joint Surg Am. 2005;87(5):1126-8.

Kitajima I, Tachibana S, Hirota Y, Nakamichi K. Acute paraspinal muscle compartment syndrome treated with surgical decompression: a case report. Am J Sports Med. 2013;30(2):283-5.

Wik L, Patterson JM, Oswald AE. Exertional paraspinal muscle rhabdomyolysis and compartment syndrome: a cause of back pain not to be missed. Clin Rheumatol. 2010;29(7):803-5.