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What Causes Rectus Abdominis Muscle Atrophy?

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Posted on Mon, 8 Jun 2015
Question: Dr. Tayal--I am the patient who since having a T12 Vertebrectomy Nov. 2012, anterior incision (2 RIBS removed) that extended posterior around to my spine, concurrently developed the problem with swelling, pain & a peculiar feeling of movement & hardening upon exercise of the area beneath the incision. Having only regained most of the feeling from the surgery this year, the numbness allowed me to exercise with no real pain 2013 & 2014. However ,the area grew during this time, shifted around & became hard at times. Anyway, in my last question to you, I told you that I had been referred to a Plastic Surgeon by the surgeon who did the last CT, showing advanced atrophy of the left rectus abdominis, likely deformation atrophy. This dx came after seeing five surgeons, who based their dx on the results of CT Scans & never physically saw or examined the area. Over these 2 1/2 years, my abdominal girth has expanded to 50", I have difficulty with balance, can't do ADLs, or even get down my steps to outside. Housework for about an hour causes excruciating back pain. Better off being numb. I lost my balance last week while reaching, staggered backwards, fell on XXXXXXX & fx hand & wrist. Had surgery & in cast. I guess, most of this you already know from my last question. The Plastic Surgeon, University of TN Medical Group, is able to fix the problem, but only when I lose weight so has referred me for bariatric surgerý. Having been inactive for so long has caused 60-70 lb gain plus the problem area probably accounts for most. After all this, my concern is the bariatric surgery probably gastric sleeve. I have never had a weight problem before. I don't snack or crave food & usually eat only one meal a day. I would like your input on this surgery for me. The Plastic Surgeon plans to do the body contouring surgery after fixing the main muscle problem. I have to say, that sounds pretty good. All is covered by Medicare & Supplemental as it was caused by the original incision & has definitely caused a deformity. Still, I worry about having part of my stomach removed. Your thoughts, please??!!


doctor
Answered by Dr. Dr. Praveen Tayal (2 hours later)
Brief Answer:
Bariatric surgery is necessary for you.

Detailed Answer:
Hello,
Thanks for posting your query.
The atrophy of rectus abdominis even if it is corrected surgically will not be successful if the weight reduction is not done. If the surgery is done without a bariatric surgery there is every chance of recurrence in next 6 months. Since you are not doing any overeating, it is mainly the inactivity that has caused a gain in the weight and the bulge.
It is best to go for gastric sleeve and then get the plastic surgery done for abdominal wall repair. It will help in better mobility on your part.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12314 Questions

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What Causes Rectus Abdominis Muscle Atrophy?

Brief Answer: Bariatric surgery is necessary for you. Detailed Answer: Hello, Thanks for posting your query. The atrophy of rectus abdominis even if it is corrected surgically will not be successful if the weight reduction is not done. If the surgery is done without a bariatric surgery there is every chance of recurrence in next 6 months. Since you are not doing any overeating, it is mainly the inactivity that has caused a gain in the weight and the bulge. It is best to go for gastric sleeve and then get the plastic surgery done for abdominal wall repair. It will help in better mobility on your part. I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out. Wishing you good health. Regards. Dr. Praveen Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal