Paralumbar compartment syndrome, a rare sequela of deadlifting: a case report and review of current literature

• Published in: Journal of Orthopaedic Surgery and Research
• Main Authors: Mark LaGreca, Thomas Falconiero, Anthony Viola, Aakash Patel, Arash Bagragheh, Brian Danshaw, Scott Rushton
• Format: Article
• Language: English
• Published: BMC 2024-06-01
• Subjects: Paralumbar compartment syndrome; Low back pain; Fasciotomies Weight Lifting
• Online Access: https://doi.org/10.1186/s13018-024-04860-3

Abstract Background Compartment syndrome is a well-known phenomenon that is most commonly reported in the extremities. However, paralumbar compartment syndrome is rarely described in available literature. The authors present a case of paralumbar compartment syndrome after high intensity deadlifting. Case presentation 53-year-old male who presented with progressively worsening low back pain and paresthesias one day after high-intensity deadlifting. Laboratory testing found the patient to be in rhabdomyolysis; he was admitted for intravenous fluid resuscitation and pain control. Orthopedics was consulted, and Magnetic Resonance Imaging revealed significant paravertebral edema and loss of muscle striation. Given the patient’s lack of improvement with intravenous and oral pain control, clinical and radiographic findings, there was significant concern for acute paralumbar compartment syndrome. The patient subsequently underwent urgent fasciotomy of bilateral paralumbar musculature with delayed closure. Conclusion Given the paucity of literature on paralumbar compartment syndrome, the authors’ goal is to promote awareness of the diagnosis, as it should be included in the differential diagnosis of intractable back pain after high exertional exercise. The current literature suggests that operative cases of paralumbar compartment syndromes have a higher rate of return to pre-operative function compared to those treated non-operatively. This case report further supports this notion. The authors recommend further study into this phenomenon, given its potential to result in persistent chronic exertional pain and irreversible tissue damage.