Phrenic Nerve Palsy After Posterior Cervical Fusion: A Case Report and Review of Literature.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2024-11-11 DOI:10.1097/BSD.0000000000001712

Thomas Falconiero, Anthony Viola, Mark LaGreca, Caleb M Yeung, Jeffrey Rihn

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引用次数: 0

Abstract

Introduction: Cervical nerve palsies, most commonly C5, are relatively common following posterior cervical decompression and fusion (PCDF) for the management of cervical myelopathy. However, phrenic nerve palsy following PCDF is a rare complication documented in only one previous case report. The authors present a case of phrenic nerve palsy following PCDF.

Methods and material: The patient is a 51-year-old male who presented with cervical myelopathy and radiculopathy as well as cervicalgia of 1 year's duration. The patient underwent C3-C6 posterior cervical decompression and fusion (PCDF). On postoperative day 5, he was found to have a right C5 nerve palsy, which improved with steroid use and physical therapy. When he returned at 7 weeks postoperatively, the patient had progressive dyspnea. A fluoroscopic exam by pulmonology revealed a right-sided phrenic nerve palsy was the cause of the dyspnea.

Results and discussion: Phrenic nerve palsy causing hemi-diaphragmatic paralysis is a rare complication of cervical spine surgery that requires a high degree of suspicion due to the nonspecific signs and symptoms. Our clinical case suggests that surgeons should bear in mind phrenic nerve palsy as a potential complication in patients with respiratory distress following cervical laminectomy.

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颈椎后路融合术后膈神经麻痹：病例报告与文献综述。

导言：颈椎后路减压融合术（PCDF）治疗颈椎病后，颈神经麻痹（最常见的是 C5）是比较常见的并发症。然而，PCDF术后膈神经麻痹是一种罕见的并发症，此前仅有一例病例报告。作者介绍了一例 PCDF 术后膈神经麻痹的病例：患者是一名 51 岁的男性，出现颈椎脊髓病和根性病变以及持续 1 年的颈痛。患者接受了 C3-C6 颈椎后路减压融合术（PCDF）。术后第 5 天，他被发现右侧 C5 神经麻痹，使用类固醇和物理治疗后症状有所改善。术后7周复诊时，患者出现了进行性呼吸困难。肺科的透视检查显示，呼吸困难的原因是右侧膈神经麻痹：膈神经麻痹导致半膈麻痹是颈椎手术的一种罕见并发症，由于症状和体征无特异性，需要高度怀疑。我们的临床病例表明，外科医生应牢记膈神经麻痹是颈椎椎板切除术后呼吸困难患者的潜在并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.