METHODS: A 77-year-old woman suffered hemidiaphragmatic paralysis caused by cervical canal and foraminal stenosis. The phrenic nerve palsy was thought to be caused by compression of the cervical spinal cord and its nerve root. The patient received a C3 laminectomy, a C4-6 laminoplasty, and a left C3-4 and C4-5 posterior foraminotomy. After surgery, she improved her maximum inspiratory pressure and respiratory function.
CONCLUSIONS: Cervical canal and foraminal stenosis may cause hemidiaphragmatic paralysis due to radiculopathy-induced phrenic nerve palsy. Laminoplasty and posterior foraminotomy can restore respiratory dysfunction related to diaphragmatic paralysis by decompressing the ventral horn of the spinal cord and spinal nerve root.
方法:一名77岁女性患者因宫颈管和椎间孔狭窄引起的膈肌麻痹。膈神经麻痹被认为是由颈脊髓及其神经根受压引起的。病人接受了C3椎板切除术,C4-6椎板成形术,左侧C3-4和C4-5后间孔切开术。手术后,她改善了最大吸气压力和呼吸功能。
结论:神经根病引起的膈神经麻痹可引起颈管和椎间孔狭窄。椎板成形术和后孔切开术可以通过减压脊髓腹角和脊神经根来恢复与膈麻痹有关的呼吸功能障碍。