Acute lumbar paraspinal compartment syndrome after radical cystectomy

BMJ Case Rep. 2024 Apr 2;17(4):e255983. doi: 10.1136/bcr-2023-255983.

Abstract

Lumbar paraspinal compartment syndrome (LPCS) is a rare diagnosis, seen in patients chronically after repeated lumbar trauma or acutely in a postoperative setting. Only a dozen cases are documented worldwide, and to date no clinical guidelines exist for the diagnosis nor the treatment.We describe the case of a 44-year-old man with excruciating lower back pain following a radical cystectomy. The postoperative laboratory values were compatible with acute rhabdomyolysis. The lumbar spine MRI showed necrosis of lumbosacral paraspinal muscles, making the diagnosis of acute LPCS. After seeking advice from different specialists, the conservative approach was chosen with combined pain treatment and physiotherapy. The patient is currently still disabled for some tasks and needs chronic pain medication.

Keywords: Back pain; Orthopaedics; Pain; Perioperative care; Urological surgery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Compartment Syndromes* / diagnosis
  • Compartment Syndromes* / etiology
  • Compartment Syndromes* / surgery
  • Cystectomy / adverse effects
  • Humans
  • Low Back Pain* / diagnosis
  • Lumbar Vertebrae / surgery
  • Lumbosacral Region / surgery
  • Magnetic Resonance Imaging
  • Male
  • Paraspinal Muscles
  • Rhabdomyolysis* / therapy