Introduction Perioperative complications associated with spinal fusion have been investigated steadily to reduce morbidity and mortality. Although there are several reports reviewing abdominal complications occurring with anterior spinal fusion, complications related to posterior spinal fusion (PSF) are rare. However, abdominal compartment syndrome (ACS) after PSF could be the most fatal and unpredictable complication in spinal surgery. Case presentation This 73-year-old man with body mass index (BMI) of 23.02, and surgical history of appendectomy 10 years prior complained of severe nausea and vomiting on the second postoperative day of L4-5 transforaminal lumbar interbody fusion (TLIF). By postoperative day 4, he presented with dyspnea and fever, and the first diagnostic impression suggested aspiration pneumonia due to vomiting. Physical examination revealed severe abdominal distention and tenderness to palpation at most of the abdomen. Computed tomography (CT) scan of abdomen and chest revealed left inguinal hernia of the small bowel with incarceration suggesting intra-abdominal hypertension (IAH), and multifocal peri-bronchial consolidation in both lungs, respectively. His respiratory symptoms progressed to respiratory failure, and he was finally mechanically ventilated in conjunction with antibiotics. After 2 weeks of intensive care, the patient's symptom had improved, and finally he was transferred to a nursing facility. Discussion IAH and ACS rarely occur as abdominal complications of PSF. We suggest several risk factors including body mass index, abdominal surgical history, and long segment fusion for development of abdominal complications.

中文翻译：

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既往接受过腹部手术的患者在后路腰椎融合术后出现腹腔间隔室综合征。

简介 与脊柱融合相关的围手术期并发症已得到持续研究，以降低发病率和死亡率。尽管有几份报告回顾了前路脊柱融合术中发生的腹部并发症，但与后路脊柱融合术 (PSF) 相关的并发症很少见。然而，PSF 后的腹腔间隔室综合征 (ACS) 可能是脊柱手术中最致命且不可预测的并发症。病例介绍 这位 73 岁男性，体重指数 (BMI) 为 23.02，10 年前有阑尾切除手术史，主诉 L4-5 经椎间孔腰椎椎间融合术 (TLIF) 术后第二天出现严重恶心和呕吐。术后第 4 天，他出现呼吸困难和发烧，第一诊断印象提示为呕吐引起的吸入性肺炎。体格检查发现严重腹胀，腹部大部分部位触诊有压痛。腹部和胸部计算机断层扫描 (CT) 扫描显示，左侧小肠腹股沟疝伴有嵌顿，提示腹内高压 (IAH)，并且双肺分别出现多灶性支气管周围实变。他的呼吸道症状发展为呼吸衰竭，最终在抗生素的配合下进行机械通气。经过两周的重症监护，患者症状有所好转，最后被转入护理机构。讨论 IAH 和 ACS 很少作为 PSF 的腹部并发症发生。我们提出了一些危险因素，包括体重指数、腹部手术史和长节段融合术，以预防腹部并发症的发生。