Anterior thigh compartment syndrome and local myonecrosis after posterior spine surgery on a jackson table

Background: Acute compartment syndrome (ACS) after posterior spinal surgery is very uncommon. Most of the reported cases have ACS in the legs related to positioning in the knee-chest position; postoperative ACS in the thighs is exceedingly rare, with only one reported case (17). Case Description: This study reports two patients who had local muscle necrosis/ACS after spine surgery in the prone position and discusses preventive measures. Both of our complications were probably related to reversing the position of the iliac crest and hip pads on a Jackson operating table, which was done to achieve better lumbar lordosis. Conclusions: Our cases indicate the need for a high index of suspicion of ACS in patients who have persistent unresolved pain and local swelling. Tissue pressure monitoring is an option in suspected cases. Iliac crest and thigh pads should not be reversed during positioning on a Jackson table.