• Georg Mattiassich, Lorenz Larcher, Markus Leitinger, Eugen Trinka, Gottfried Wechselberger, and Heinrich Schubert.
• Trauma Center Unfallkrankenhaus Linz, Teaching Hospital of the Paracelsus Medical University Salzburg, Linz, Austria. georg.mattiassich@gmx.at.
• Bmc Musculoskel Dis. 2013 Jan 1; 14: 259.

BackgroundAcute 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.Case PresentationA 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.ConclusionsWe 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.

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