Brachial Plexus Paralysis after Thoracotomy through Median Sternotomy: A New Case Report of Poor Prognosis Despite Lower Radiculopathy.

Journal of Orthopaedic Case Reports Pub Date : 2025-01-01 DOI:10.13107/jocr.2025.v15.i01.5132

Ryunosuke Fukushi

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Abstract

Introduction: 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.

Case report: 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.

Conclusion: 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.

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