Lumbar paraspinal compartment syndrome. A case report with physiologic and anatomic studies

Area of Science:

• Orthopedics
• Sports Medicine
• Anatomy

Background:

• Exertional low-back pain can be debilitating.
• The erector spinae muscles are crucial for spinal stability.
• Compartment syndrome is a recognized condition in skeletal muscles.

Observation:

• A 24-year-old man experienced severe low-back pain and muscle spasm post-exertion.
• Clinical findings included fever, elevated white blood cell count, muscle enzymes, and myoglobinuria.
• CT scans revealed paraspinal muscle edema and necrosis.

Findings:

• Cadaveric dissections confirmed the erector spinae muscles are enclosed in a fascial sheath.
• Intracompartmental pressure measurements in healthy males showed physiological behavior similar to other compartments.
• Pressure varied with body posture, isometric contraction, and intra-abdominal pressure.

Implications:

• The findings support the diagnosis of paraspinal compartment syndrome.
• This condition may be an underrecognized cause of exertional low-back pain.
• Understanding paraspinal compartment pressure dynamics is crucial for diagnosis and management.