J Korean Soc Spine Surg.  2018 Sep;25(3):133-139. 10.4184/jkss.2018.25.3.133.

Acute Lumbar Paraspinal Compartment Syndrome after Weightlifting: A Case Report

• Ha JY
• Lee JS
• Cho YS
• Kim KW

• KMID: 2421606
• DOI: http://doi.org/10.4184/jkss.2018.25.3.133

Abstract

STUDY DESIGN: Case report.
OBJECTIVES
To report 2 cases of acute lumbar paraspinal compartment syndrome due to weightlifting. SUMMARY OF LITERATURE REVIEW: Acute lumbar paraspinal compartment syndrome is very rare, but it causes muscle necrosis and acute renal failure. Therefore, it should be treated immediately.
MATERIALS AND METHODS
A 31-year-old male patient and a 30-year-old male patient visited the emergency room due to severe back pain. The left paraspinal compartment pressure of the 31-year-old patient was measured as 35 mm Hg using the Whitesides technique. The paraspinal compartment pressure of the 30-year-old patient was measured as 22 mm Hg on the left side and 30 mm Hg on the right side. We diagnosed acute lumbar paraspinal compartment syndrome and performed a fasciotomy. This study received Institutional Review Board approval (ID: SC18ZESE0032).
RESULTS
Lab findings improved after fasciotomy. The operative wounds healed after fasciocutaneous flap placement.
CONCLUSIONS
Acute lumbar paraspinal compartment syndrome is very rare, but should be considered in patients with severe back pain.

Keyword

Paraspinal compartment syndrome; Fasciotomy; Rhabdomyolysis

MeSH Terms

Acute Kidney Injury
Adult
Back Pain
Compartment Syndromes*
Emergency Service, Hospital
Ethics Committees, Research
Humans
Male
Necrosis
Rhabdomyolysis
Wounds and Injuries

Figure

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  Fig. 1. Lumbar X-ray. (A) Lumbar anteroposterior X-ray not showing ileus. (B) Lumbar lateral X-ray showing loss of lumbar lordosis.

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  Fig. 2. Lumbar magnetic resonance imaging. (A) T2-weighted coronal magnetic resonance imaging showing high signal intensity at the left multifidus muscle and the longissimus muscle (arrow). (B) T2-weighted axial magnetic resonance imaging showing high signal intensity at the left erector spinae muscle (arrow).

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  Fig. 3. Lumbar X-ray. (A) Lumbar anteroposterior X-ray not showing ileus. (B) Lumbar lateral X-ray showing loss of lumbar lordosis.

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  Fig. 4. Lumbar magnetic resonance imaging. (A) T2-weighted coronal magnetic resonance imaging showing bilateral high signal intensity and edema at the multifidus, longissimus, iliocostalis lumborum, and quadratus lumborum muscles (arrows). (B) T2-weighted axial magnetic resonance imaging showing bilateral high signal intensity at the erector spinae muscles (arrows).

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  Fig. 5. Intraoperative clinical photo of case 2. (A) The color of the erector spinae had changed in several areas. (B) The color of the erector spinae had changed to gray.

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  Fig. 6. Creatine phosphokinase levels over time.

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