Abstract
Compartment syndrome can be a limb-threatening emergency that may require immediate intervention. It usually involves the extremities but any closed compartment of the body is susceptible to it. Paraspinal compartment extends on both sides of the spine. Prolonged lying on the back in unconscious patients leads to muscle edema which eventually leads to increase pressure in the compartment. Neurovascular comprise is a dreaded complication of compartment syndrome. Paraspinal compartment is a potential site of compartment syndrome particularly in unconscious patients and it requires prompt diagnosis, careful monitoring, immediate medical attention and even warranting surgical intervention in certain cases.
Highlights
Compartment syndrome can be a limb-threatening emergency that may require immediate intervention
We describe a case of paraspinal compartment syndrome in an unconscious patient, secondary to polysubstance abuse and seizures
Prolonged periods of pressure on the compartments of the back the paraspinal compartment can lead to paraspinal compartment syndrome which can be missed in an unconscious patient
Summary
Compartment syndrome can be a limb-threatening emergency that may require immediate intervention. Prolonged periods of pressure on the compartments of the back the paraspinal compartment can lead to paraspinal compartment syndrome which can be missed in an unconscious patient This requires performing a thorough clinical examination in patients with unexplained elevations in creatine kinase (CK) levels that are not being cleared from the body. Serial measurements of CK did not show significant improvement despite fluid resuscitation and stayed at 4530 units/L even after 24 hours of significant hydration This prompted a complete re-examination of the body to evaluate for compartment syndrome which revealed significant swelling on the left paraspinal area in the lower thoracic and lumbar region extending laterally along the external oblique muscle.
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