title: Paravertebral compartment syndrome after training causing severe back pain in an amateur rugby player: report of a rare case and review of the literature.
abstract: BACKGROUND
  Acute compartment syndrome (CS) of the paravertebral muscles without external trauma is rarely reported in literature. Not all of clinical symptoms for CS are applicable to the paravertebral region.
  
  
  METHODS
  A 30-year-old amateur rugby player was suffering from increasing back pain following exertional training specially targeting back muscles. He presented with hardly treatable pain of the lumbar spine, dysaesthesia of the left paravertebral lumbar region as well as elevated muscle enzymes. Magnetic resonance imaging (MRI) showed an edema of the paravertebral muscles. Compartment pressure measurement revealed increased values of 47 mmHg on the left side. Seventy-two hours after onset of back pain a fasciotomy of the superficial thoracolumbar fascia was performed. Immediately postoperatively the clinical condition improved and enzyme levels significantly decreased. The patient started with light training exercises 3 weeks after the operation.
  
  
  CONCLUSIONS
  We present a rare case of an exercise-induced compartment syndrome of the paravertebral muscles and set it in the context of existing literature comparing various treatment options and outcomes. Where there is evidence of paravertebral compartment syndrome we recommend immediate fasciotomy to prevent rhabdomyolysis and further consequential diseases.
authors.affiliation: Trauma Center Unfallkrankenhaus Linz, Teaching Hospital of the Paracelsus Medical University Salzburg, Linz, Austria. georg.mattiassich@gmx.at.
authors.forename: Georg
authors.initials: G
authors.lastname: Mattiassich
authors.forename: Lorenz
authors.initials: L
authors.lastname: Larcher
authors.forename: Markus
authors.initials: M
authors.lastname: Leitinger
authors.forename: Eugen
authors.initials: E
authors.lastname: Trinka
authors.forename: Gottfried
authors.initials: G
authors.lastname: Wechselberger
authors.forename: Heinrich
authors.initials: H
authors.lastname: Schubert
mesh_terms: D000208:Acute Disease; D000328:Adult; D001706:Biopsy; D003161:Compartment Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods; D000071938:Fasciotomy; D005538:Football; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009336:Necrosis; D010147:Pain Measurement; D064170:Paraspinal Muscles / Q000473:pathology / Q000503:physiopathology*; D011237:Predictive Value of Tests; D020127:Recovery of Function; D055070:Resistance Training / Q000009:adverse effects*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome