Acute Post-operative Lumbar Paraspinal Compartment Syndrome Following Revision Total Joint Arthroplasty: A Case Report

Introduction: Lumbar paraspinal compartment syndrome has been infrequently reported in the literature and often overlooked in the evaluation of acute low back pain. In the post-operative setting, few cases have been described, but none after total joint arthroplasty, and appropriate management remains controversial. Case Report: A 55-year-old male developed severe low back pain and left lower extremity radiculopathy in the immediate post-operative period following revision total knee arthroplasty. Magnetic resonance imaging demonstrated diffuse edema throughout the left lumbosacral paraspinal musculature, and he was found to have an elevated creatine kinase level. This was consistent with acute paraspinal compartment syndrome, which was successfully managed with conservative treatment for the associated rhabdomyolysis. By 1-year follow-up, he demonstrated resolution of his symptoms and returned to baseline activity level. Conclusion: Paraspinal compartment syndrome must be considered in the differential diagnosis of low back pain that onsets in the immediate post-operative period. Non-operative management can result in positive outcomes.