GT FINDINGS OF ATROPHY OF CHEST-WALL MUSCLE AFTER THORACOTOMY - RELATIONSHIP BETWEEN MUSCLES INVOLVED AND TYPE OF SURGERY

OBJECTIVE. Postthoracotomy atrophy of chest wall muscles results from nerve injury during surgery. After encountering patients with differen t patterns of chest wall muscular atrophy postthoracotomy, we performe d this study to determine the relationship between type of thoracotomy and atrophic muscles as seen on CT scans. MATERIALS AND METHODS. CT s cans of 58 patients who had previously undergone unilateral thoracotom y were reviewed, Forty patients had a posterolateral thoracotomy, and 18 had an anterolateral thoracotomy. In two cases, the incision extend ed posteriorly. Atrophy seen on CT scans was defined as a marked decre ase in size or thickness of a muscle compared with the muscle on the o ther side. RESULTS. Atrophy of the latissimus dorsi muscle and of the inferior portion of the serratus anterior muscle was detected on CT sc ans in 40 patients. No atrophy was found in 16 patients. The remaining two displayed atrophy only in the serratus anterior muscle. Atrophy o f the latissimus dorsi muscle and of the inferior portion of the serra tus anterior muscle developed in all patients who had a posterolateral thoracotomy. Atrophy developed in only two of the 18 patients who had an anterolateral thoracotomy, and in these two, the incision had been extended posteriorly. CONCLUSION. A direct correlation was found betw een type of thoracotomy and site of atrophy of the chest wall muscles seen on CT scans. This finding may account for different CT appearance s of the thoracic wall in patients who have had thoracic surgery.