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Case Reports
. 2018 Mar 4:2018:6195179.
doi: 10.1155/2018/6195179. eCollection 2018.

Resolution of Right Hemidiaphragm Paralysis following Cervical Foraminotomies

Neal Singleton  1 , Matthew Bowman  1 , David Bartle  1
Affiliations
Case Reports

Resolution of Right Hemidiaphragm Paralysis following Cervical Foraminotomies

Neal Singleton et al. Case Rep Orthop. .

Abstract

Introduction: Hemidiaphragm paralysis secondary to phrenic nerve palsy is a well-recognised medical condition. There are few case reports in the literature documenting resolution of hemidiaphragm paralysis following cervical spine surgery. This case report documents our experience with one such case.

Case presentation: A 64-year-old man was referred to the orthopaedic service with right hemidiaphragm paralysis. He had a previous history of asbestos exposure and polio and was initially seen and investigated by the respiratory physicians. He also reported intermittent neck pain and an MRI scan showed right-sided cervical foraminal stenosis. He underwent posterior right C3/4 and C4/5 foraminotomies, and by three months postoperatively, his hemidiaphragm paralysis had resolved and his shortness of breath had also improved.

Conclusion: This report documents a unique case of resolution of hemidiaphragm paralysis following posterior unilateral cervical foraminotomies.

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Figures

Figure 1
Figure 1
Preoperative chest radiograph in a 64-year-old man with right-sided stenosis at C3/4 and C4/5 demonstrating an elevated right hemidiaphragm.
Figure 2
Figure 2
Preoperative AP and oblique cervical spine radiographs showing degenerative spondylosis.
Figure 3
Figure 3
Preoperative T2-weighted sagittal MRI scan at the C3/4 level with corresponding axial sequence illustrating right-sided foraminal stenosis due to a combination of disc bulge, uncovertebral osteophyte, and facet joint hypertrophy.
Figure 4
Figure 4
Preoperative CT scan of the cervical spine with sagittal slice and corresponding axial slice at the C3/4 level illustrating right-sided foraminal stenosis.
Figure 5
Figure 5
Chest radiograph three months postoperatively showing resolution of right hemidiaphragm paralysis.
Figure 6
Figure 6
Comparison of preoperative and postoperative spirometry results showing marked improvement in respiratory function.
See this image and copyright information in PMC

References

    1. Gibson G. J. Diaphragmatic paresis: pathophysiology, clinical features, and investigation. Thorax. 1989;44(11):960–970. doi: 10.1136/thx.44.11.960. - DOI - PMC - PubMed
    1. Parke W., Whalen J. Phrenic paresis—a possible additional spinal cord dysfunction induced by neck manipulation in cervical spondylotic myelopathy: a report of two cases with anatomical and clinical considerations. Clinical Anatomy. 2001;14(3):173–178. doi: 10.1002/ca.1029. - DOI - PubMed
    1. Merino-Ramirez M., Juan G., Ramon M., Cortijo J., Morcillo E. Diaphragmatic paralysis following minor cervical trauma. Muscle and Nerve. 2007;36(2):p. 267. doi: 10.1002/mus.20754. - DOI - PubMed
    1. Hayashi H., Kihara S., Hoshimaru M., Hashimoto N. Diaphragmatic paralysis caused by cervical spondylosis. Case report. Journal of Neurosurgery: Spine. 2005;2(5):604–607. doi: 10.3171/spi.2005.2.5.0604. - DOI - PubMed
    1. Fregni F., Conceicao S., Souza G., Taricco M., Mutarelli E. Phrenic paresis and respiratory insufficiency associated with cervical spondylotic myelopathy. Acta Neurochirurgica. 2004;146(3):309–312. doi: 10.1007/s00701-003-0201-4. - DOI - PubMed

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