Phrenic Nerve Dysfunction Secondary to Cervical Neuroforaminal Stenosis: A Literature Review

World Neurosurg. 2022 Nov:167:74-77. doi: 10.1016/j.wneu.2022.09.009. Epub 2022 Sep 8.


Background: Phrenic nerve dysfunction has been associated with cervical neuroforaminal stenosis in limited case reports and case-controlled studies. It is unclear if magnetic resonance imaging of the cervical spine should be included in the workup of patients with pulmonary dysfunction. A systematic review of the current literature was conducted on the topic to provide an outline of the body of knowledge and some guidance for neurosurgeons that receive these patient referrals.

Methods: A systematic literature review was conducted through the PubMed database to identify articles related to phrenic nerve dysfunction secondary to cervical stenosis.

Results: A total of 12 case reports were found. The median subject age was 64 years, 11 were male. Presenting symptoms included shortness of breath (n = 9), radiculopathy (n = 7), myelopathy (n = 5), reduced pulmonary function (n = 6), weakness (n = 4), and neck pain (n = 5). Ten of these patients underwent surgical intervention, all having improvements in their pulmonary and neurological symptoms at follow-up ranging from 10 days to 2 years.

Conclusions: Cervical stenosis, resulting in neuroforaminal stenosis, may be related to phrenic nerve dysfunction in select patients with idiopathic diaphragmatic paralysis or pulmonary dysfunction. Surgical decompression improves pulmonary and neurological symptoms.

Keywords: Cervical stenosis; Phrenic nerve; Respiratory dysfunction.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery
  • Constriction, Pathologic / complications
  • Constriction, Pathologic / diagnostic imaging
  • Constriction, Pathologic / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Phrenic Nerve / diagnostic imaging
  • Respiratory Paralysis* / diagnostic imaging
  • Respiratory Paralysis* / etiology
  • Respiratory Paralysis* / surgery
  • Spinal Cord Diseases* / surgery