Postoperative lumbar paraspinal compartment syndrome

BMJ Case Rep. 2021 Mar 29;14(3):e236040. doi: 10.1136/bcr-2020-236040.

Abstract

Lower lumbar paraspinal muscles constitute a compartment as they are surrounded by distinct fascial and bony boundaries. Lumbar paraspinal compartment syndrome is a rare entity, often caused by intense exercise, but also can be a postoperative complication. We present a 60-year-old man with low back pain, numbness in the left lower back and radicular pain in the left lower extremity, which started after a surgery that involved prolonged positioning on the left side 7 years before, and persisted to the day of evaluation. There was an immediate transient rise in the creatine kinase after surgery. Electromyography showed a left lower lumbar-sacral plexopathy and a lumbar spine MRI revealed fatty infiltration of the lower lumbar-sacral paraspinal muscles. The emergence of radicular lower limb pain was likely due to the compression of the proximal portion of lumbar-sacral plexus during the acute stage of rhabdomyolysis.

Keywords: neuroimaging; neurological injury; pain (neurology).

Publication types

  • Case Reports

MeSH terms

  • Compartment Syndromes* / diagnosis
  • Compartment Syndromes* / etiology
  • Compartment Syndromes* / surgery
  • Humans
  • Low Back Pain* / etiology
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery
  • Lumbosacral Region
  • Male
  • Middle Aged
  • Paraspinal Muscles / diagnostic imaging
  • Rhabdomyolysis* / diagnosis
  • Rhabdomyolysis* / etiology