Acute Paraspinal Compartment Syndrome Research Articles

Acute Paraspinal Compartment Syndrome in an Unconscious Patient

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.

長時間の胡坐を契機に急性傍脊柱筋コンパートメント症候群，クラッシュ症候群を来した1例(A case of crush syndrome with acute paraspinal compartment syndrome caused by prolonged sitting in a cross–legged position)

要旨長時間の胡坐という静的な機序により急性傍脊柱筋コンパートメント症候群とクラッシュ症候群を発症した初めての症例を経験したので報告する。症例は27歳の男性で，基礎疾患に双極性障害と不眠症がある。新規に処方された向精神薬を服用後に胡坐での前傾姿勢で入眠し，13時間後に腰背部の激痛により同一姿勢のまま覚醒して当院へ搬送された。来院時ショック状態であり，下肢，鼠径部外側にそれぞれ発赤，腫脹を認め，腰背部の傍脊柱筋は両側ともに硬直がみられた。また，両下肢は完全麻痺であった。検査所見では横紋筋融解症，急性腎傷害，高カリウム血症，代謝性アシドーシス，ミオグロビン尿を認めた。単純CTでは下肢，臀部に加えて両側の多裂筋に低吸収域を呈し，MRI T2強調像でも同部位に高信号像を認めた。各筋区画内圧は下肢，多裂筋で上昇していたため，下腿，大腿に対する減張切開術後にICUへ入院した。第2病日に臀部への減張切開術を，第19病日に感染制御困難となったため右下腿切断術をそれぞれ施行し，転院時には両下肢は完全麻痺のままであった。

Acute Paraspinal Compartment Syndrome Related to Use of Proprietary Weight Loss Product, by a Patient with Sodium Channelopathy

Paraspinal compartment syndrome is a rare cause of lower back pain that remains under-recognized and under-treated and which can result in prolonged and debilitating pain. We present the case of a young female with paramyotonia congenita due to sodium chanelopathy, who developed acute paraspinal compartment syndrome after ingestion of an ephedrine containing proprietary weight loss product. We highlight the challenges in diagnosis and management and review potential precipitating factors and mechanisms underlying the clinical features.

Poster 20 Acute Paraspinal Compartment Syndrome: A Diagnosis to Consider

Poster 20 Acute Paraspinal Compartment Syndrome: A Diagnosis to Consider

Acute paraspinal compartment syndrome as an unusual cause of severe low back pain

This report describes a case of acute paraspinal compartment syndrome in a 25-year-old man. The diagnosis was significantly delayed, perhaps to some extent because of the rarity of the condition. The patient was managed with forced diuresis, analgesia and hyperbaric oxygen therapy. The discussion addresses an unusual site for compartment syndrome and a diagnosis not commonly considered in the differential of low back pain. Treatment options are discussed and we review previous published case reports.

Acute Paraspinal Compartment Syndrome

Acute compartment syndrome is the condition of raised pressure within an enclosed compartment, such that the perfusion and the function of the tissues within are compromised, resulting in ischemia and eventually necrosis. Although, in theory, it can occur in any compartment, it is most commonly seen in the lower limb. We describe a rare case of acute compartment syndrome in the paraspinal muscles that responded well to surgical decompression. Our patient was informed that data concerning this case would be submitted for publication. Athirty-five-year-old man on the third day of a skiing holiday presented to the emergency department because of severe, unrelenting pain in the right lumbosacral paraspinal area, radiating across the abdomen to the groin. The pain had been present for four hours and had begun spontaneously with no history of trauma. In retrospect, the patient had experienced similar but milder pains during previous ski trips and during long-distance running. There was associated numbness in the right lumbosacral area. Positive findings on physical examination were bilateral paraspinal muscle rigidity associated with swelling, marked tenderness, and loss of the lumbar lordosis. There was dense loss of sensation in the paraspinal area to the midaxillary line and altered sensation extending anteriorly to the midline. Reduced abdominal muscle tone on the right side, resulting in asymmetry, was also noted. Active movement of the spine was minimal and exacerbated the pain. The patient had mild tenderness of the abdomen with absent bowel sounds. The initial differential diagnosis included a renal stone, a herniated disc, discitis, and a retroperitoneal abnormality. A urine specimen was dark in appearance, and analysis revealed 3+ myoglobinuria. Blood chemistry studies showed elevation of aspartate aminotransferase (804 IU/L; …