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What Causes Tenting Of Diaphragm Post Surgery For T 12 Fracture?
Question: I had an 8 foot fall onto my back and a T12 burst fracture with 4 broke ribs on the right. The surgeon fixed my spine with a xlif cage with no issues with a lateral approach. Now I have right diaphragm tenting, but my sat is 98% and I can do 2L on my incentive spirometry. Is the tenting do to the fall or damage to the phrenic nerve? No scan results mention anything about my diaphgram. She says I don't need a sniff test. Can phrenic nerve damage be diagnosed or treated? Should I have an EMG to see if there's nerve impulses to the diaphgram? I was not born with tenting fyi. Please advise. XXXXXX
Brief Answer:
It is very difficult to revert phrenic nerve injury.
Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Yes, possibility of phrenic nerve damage due fall is more. And this is causing tenting of diaphragm.
If you are asymptomatic and doing good on spirometry, no need to worry much about this tenting and hence no need for search for the cause.
Direct phrenic nerve damage or injury can be diagnosed only on operation theater where we can see cut or torn phrenic nerve. Indirectly, we can assess diaphragm functions, movements (sniff test) etc. And phrenic nerve injury is treated surgically but only in symptomatic patients. And again results are not always positive.
If you are asymptomatic then no need for further tests and evaluation.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
It is very difficult to revert phrenic nerve injury.
Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Yes, possibility of phrenic nerve damage due fall is more. And this is causing tenting of diaphragm.
If you are asymptomatic and doing good on spirometry, no need to worry much about this tenting and hence no need for search for the cause.
Direct phrenic nerve damage or injury can be diagnosed only on operation theater where we can see cut or torn phrenic nerve. Indirectly, we can assess diaphragm functions, movements (sniff test) etc. And phrenic nerve injury is treated surgically but only in symptomatic patients. And again results are not always positive.
If you are asymptomatic then no need for further tests and evaluation.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. Your answer actually made sense and I followed it as I am a Respiratory Therapist. I'm just wondering if I am going to be more susceptible to pneumonia?
Also, since I'm having no issues currently in regards to this I guess its a moot issue, but I wonder if its the nerve that is affected or the diaphragm muscle itself, since the diaphragm is attached to t12. Care to offer an unofficial opinion?
Thank you. XXXXXXX XXXXX
Also, since I'm having no issues currently in regards to this I guess its a moot issue, but I wonder if its the nerve that is affected or the diaphragm muscle itself, since the diaphragm is attached to t12. Care to offer an unofficial opinion?
Thank you. XXXXXXX XXXXX
Brief Answer:
Yes, risk of lower lobe atelectesis and pneumonia is more.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I am glad that you are also related to medical field.
Yes, you are right. Risk of lower lobe atelectesis and pneumonia is more.
But to avoid these, you should avoid smoking, do deep breathing and spirometry exercises, apply healthy lifestyle and get done periodic chest x ray every 12 months.
Don't worry, this won't affect your health.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Yes, risk of lower lobe atelectesis and pneumonia is more.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I am glad that you are also related to medical field.
Yes, you are right. Risk of lower lobe atelectesis and pneumonia is more.
But to avoid these, you should avoid smoking, do deep breathing and spirometry exercises, apply healthy lifestyle and get done periodic chest x ray every 12 months.
Don't worry, this won't affect your health.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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