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Lumbar paraspinal myonecrosis after abdominal vascular surgery: a case report
N Osamura1, K Takahashi, M Endo
1Department of Orthopaedic Surgery, Ishikawa Prefectural Central Hospital, Ishikawa, Japan.
Study Design:
Case report.
Objectives:
Lumbar paraspinal myonecrosis after abdominal vascular surgery.
Summary Of Background Data:
Lumbar paraspinal myonecrosis does not appear to have been reported previously.
Methods:
A patient who had severe back pain after abdominal vascular surgery was observed with computed tomographic scans and histologic examination of a specimen obtained in open biopsy.
Results:
Computed tomographic scans of the lumbar region demonstrated muscle swelling of the unilateral paraspinal compartment. Histologic examinations of affected muscle revealed fresh ischemic necrosis. A compartmental syndrome was considered from the patient's clinical presentation and radiographic and histologic features. An accompanying secondary infection led to an extensive abscess in the paraspinal compartment. The patient resumed active daily life after aggressive débridements of infected and necrotic muscles.
Conclusions:
A compartmental syndrome in the paraspinal muscle should be kept in mind as a potential cause of acute back pain especially after abdominal vascular surgery.