Gluteal compartment syndrome after lumbar laminectomy

Abstract

Gluteal compartment syndrome may, in its severe form, have serious consequences. It may result in severe rhabdomyolysis, and if left untreated it can result in acute renal collapse, multiorgan failure and even death. The present report concerns a patient who developed a gluteal compartment syndrome after lumbar surgery. The syndrome was complicated by acute renal failure with high concentrations of serum creatinine kinase, myoglobin, and potassium, requiring acute haemodialysis before surgical release. The operation revealed increased intracompartmental pressure with weak or absent reaction of muscles to electric stimulation. To prevent the development of gluteal compartment syndrome during operative procedures, it is important to avoid harmful pressure to the gluteal regions on the operating table. It is also important to optimise muscle circulation by adequate hydration therapy and avoidance of nephrotoxic stimuli. If gluteal compartment syndrome develops, immediate diagnosis and surgical decompression are mandatory .

‘A pain in the buttock’: A case report of gluteal compartment syndrome after robotic partial nephrectomy

“… BMI: body mass index; AAA: abdominal aortic aneurysm; BMI: body mass index; EVAR: endovascular aneurysm repair; NR: not reported. References: Benevides & Nochi Júnior (2006); Cameron-Gagné et al (2018); Chew et al (2009); Hau et al (2016); Keene et al (2010); Kumar et al (2007); Matta & Kelley (2014); Mohanty et al (2019); O’Leary et al (2010); Oates et al (2016); Osteen & Haque (2012); Pereira & Heath (2015); Polacek et al (2009); Pua et al (2005); Reisiger et al (2005); Rudolph et al (2011); Sarwar & Ting (2017); Somayaji et al (2005); Ting et al (2015); Viviani et al (2016). …”

“…CS is often described in the context of a fracture or vascular injury, and occurs in a distal extremity (Shore et al 2013). Gluteal compartment syndrome (GCS) is one of the rarest types of CS (Smith et al 2012) and cases have been described following prolonged immobilisation secondary to substance abuse (Kuhlman & Gwathmey 2018, Mustafa et al 2009), post-traumatic, after orthopaedic surgery, bone biopsy and intramuscular infection (Kumar et al 2007, Mohanty et al 2019, Osteen & Haque 2012, Polacek et al 2009, Somayaji et al 2005). Early identification and treatment of this condition are essential as the patient is at risk of developing irreversible sequelae, such as rhabdomyolysis, renal failure, multiorgan failure and even death (Mustafa et al 2009).…”

Missed positional gluteal compartment syndrome in an obese patient after foot surgery: a case report

“…Table 1 shows the details of the included papers/ cases. All studies were retrospective case reports [ 6 , 10 – 17 ]. The average age was 53.2 years old, with most cases (84.6%) being males and the average BMI was 33.7 (from the studies that recorded BMI).…”

“… Fasciotomy, Hemodialysis despite the aggressive fluid replacement 7 h post-op The patient required five courses of hemodialysis. Continued to have pain and was discharged dependent on a wheelchair due to moderate gluteal pain and bilateral insufficiency of gluteal muscles Polacek, 2009 [ 6 ] : Gluteal compartment syndrome after lumbar laminectomy 65yo M BMI 38, PMH: obesity, CKD III, DM2, HTN Lumbar laminectomy Elbow - 4 h Inhalation anesthesia The elbow-knee position with side and buttock support Left gluteal compartment Yes Increasing pain in both gluteal regions, especially on the left side. The pain did not respond to analgesic treatment.…”

“…Trauma, vascular injury, infection, surgical positioning, and prolonged immobilization from drug or alcohol intoxication are the most common causes of gluteal compartment syndrome [ 1 – 4 ]. Early recognition and treatment can help to prevent long term complications such as residual sciatic nerve problems or renal failure from rhabdomyolysis [ 5 , 6 ].…”