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Phrenic nerve palsy after cervical laminectomy and fusion.


ABSTRACT:

Background

Phrenic nerve palsy is a rare complication of cervical spine surgery. There are no previously reported cases of unilateral diaphragmatic paralysis following posterior cervical spine surgery. Here, we present a case of a 69 year-old Caucasian male with severe cervical stenosis with myelopathy who underwent posterior spinal instrumentation and fusion (PSIF) from C2 to T2, with laminectomies at C3-C7.

Outcome

The patient developed respiratory distress post-operatively and was found to have an elevated hemidiaphragm secondary to phrenic nerve palsy. He was treated with respiratory support, with significant improvement in dyspnea. He was also noted to have a left C5 palsy affecting his deltoid function and proximal upper extremity sensation which gradually improved.

Conclusions

This is the first reported case of unilateral diaphragmatic paralysis causing dyspnea due to phrenic nerve palsy following cervical spine surgery. This rare complication should be kept in mind when assessing any patient with respiratory distress following cervical spine surgery.

SUBMITTER: Moon AS 

PROVIDER: S-EPMC8820014 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Phrenic nerve palsy after cervical laminectomy and fusion.

Moon Andrew S AS   Pearson Jeffrey M JM   Pittman Jason L JL  

North American Spine Society journal 20200924


<h4>Background</h4>Phrenic nerve palsy is a rare complication of cervical spine surgery. There are no previously reported cases of unilateral diaphragmatic paralysis following posterior cervical spine surgery. Here, we present a case of a 69 year-old Caucasian male with severe cervical stenosis with myelopathy who underwent posterior spinal instrumentation and fusion (PSIF) from C2 to T2, with laminectomies at C3-C7.<h4>Outcome</h4>The patient developed respiratory distress post-operatively and  ...[more]

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