Compartment syndrome of the upper and the lower extremities is a well-known entity in emergency
medicine and traumatology. However, compartment syndrome of the paraspinal musculature is a very rare
cause of acute back pain and may be missed at presentation despite its clinical importance. Therefore, we
present a case of paraspinal compartment syndrome embedded in an overview of the actual literature. A 21-
year-old woman presented with acute back pain refractory to analgesia with opiates after a tug of war match.
A CT-scan of the abdomen demonstrated paraspinal swelling and an MRI ruled out intra-spinal pathologies.
A compartment measurement yielded a pressure of 135mmHg. Even though conservative treatment attempts
are often described, an emergency fasciotomy was carried out. Further rehabilitation was uneventful.
Nevertheless, the timing of fasciotomy in the paraspinal region is under discussion, especially due to very
rare experiences. Even if surgery is delayed by more than 24 hours following symptom onset, favourable
postoperative outcomes have been observed.
Acute Lumbar Paraspinal Compartment Syndrome after a Tug of War: A Case Report and Review of the Literature
