Abstract:
Although compartment syndrome can occur in any compartment in the body, it rarely occurs in the paraspinal musculature and has therefore only been reported in a few case reports. Despite its rare occurrence, acute paraspinal compartment syndrome has been shown to occur secondary to reperfusion injury and traumatic and atraumatic causes. Diagnosis can be based on clinical examination findings, MRI or CT studies, or through direct measurement of intramuscular pressures. Conservative management should only be used in the setting of chronic presentation. Operative decompression via fasciotomy in cases of acute presentation may improve the patient\'s symptoms and outcomes. When treating acute paraspinal compartment syndrome via surgical decompression, an important aspect is the anatomical consideration. Although grouped under one name, each paraspinal muscle is enclosed within its own fascial compartment, all of which must be addressed to achieve an adequate decompression. The authors present the case of a 43-year-old female patient who presented to the emergency department with increasing low-back and flank pain after a fall. Associated sensory deficits in a cutaneous distribution combined with imaging and clinical findings contributed to the diagnosis of acute traumatic paraspinal compartment syndrome. The authors discuss this case and describe their surgical technique for managing acute paraspinal compartment syndrome.
摘要:
尽管筋膜室综合征可以发生在身体的任何一个部位,它很少发生在椎旁肌肉组织中,因此仅在少数病例报告中报告。尽管它很少发生,急性椎管旁间室综合征已被证明是继发于再灌注损伤和创伤和非创伤原因。诊断可以基于临床检查结果,MRI或CT检查,或通过直接测量肌肉内压力。保守管理应仅在慢性表现的情况下使用。在急性表现的情况下,通过筋膜切开术进行减压可以改善患者的症状和预后。当通过手术减压治疗急性椎管旁综合征时,一个重要的方面是解剖学的考虑。虽然分组在一个名字下,每个椎旁肌都被封闭在自己的筋膜室中,所有这些都必须解决,以实现充分的减压。作者介绍了一名43岁的女性患者的情况,该患者跌倒后出现腰背和侧腹疼痛增加的情况。皮肤分布中相关的感觉缺陷结合影像学和临床表现有助于诊断急性创伤性椎管旁间隔综合征。作者讨论了这种情况,并描述了他们治疗急性椎管旁间室综合征的手术技术。