Fukushi Ryunosuke
Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
J Orthop Case Rep. 2025 Jan;15(1):79-82. doi: 10.13107/jocr.2025.v15.i01.5132.
Thoracotomy through a median sternotomy is considered a risk factor for brachial plexus paralysis. We report a new case of poor prognosis despite lower radiculopathy.
A 53-year-old female (height 152 cm and weight 41 kg) complained of motor impairment in her left fingers, numbness in her left forearm, and paresthesia after left thoracotomy. A descending thoracic aortic replacement (20 mg J-graft 1 branch) had been performed through a left thoracotomy. After the surgery, she noticed movement disorder, numbness, and paresthesia and was referred to an orthopedic surgeon. Vitamin B12 formulation was administered, and she was followed up. The patient recovered motor function 8 months postoperatively, but numbness in the median nerve region remained 18 months after thoracotomy.
Even if brachial plexus paralysis persists as lower radiculopathy, nerve compression is relatively more severe in petite patients, suggesting that the prognosis may be poor.
经正中胸骨切开术进行开胸手术被认为是臂丛神经麻痹的一个危险因素。我们报告一例尽管为下神经根病但预后较差的新病例。
一名53岁女性（身高152厘米，体重41千克）在左胸开胸手术后出现左手手指运动障碍、左前臂麻木和感觉异常。通过左胸开胸手术进行了降主动脉置换术（20毫克J型移植物1分支）。手术后，她出现了运动障碍、麻木和感觉异常，并被转诊至骨科医生处。给予了维生素B12制剂，并对她进行了随访。患者术后8个月恢复了运动功能，但开胸手术后18个月正中神经区域仍有麻木感。
即使臂丛神经麻痹以下神经根病的形式持续存在，身材矮小的患者神经受压相对更严重，提示预后可能较差。
