Abstract
Background:Cervical C5 nerve root palsies may occur in between 0% and 30% of routine anterior or posterior cervical spine operations. They are largely attributed to traction injuries/increased cord migration following anterior/posterior decompressions. Of interest, almost all studies cite spontaneous resolution of these deficits without surgery with 3–24 postoperative months.Methods:Different studies cite various frequencies for C5 root palsies following anterior or posterior cervical spine surgery. In their combined anterior/posterior series involving C4-C5 level decompressions, Libelski et al. cited up to a 12% incidence of C5 palsies. In Gu et al. series, C5 root palsies occurred in 3.1% of double-door laminoplasty, 4.5% of open-door laminoplasty, and 11.3% of laminectomy. Miller et al. observed an intermediate 6.9% frequency of C5 palsies followed by posterior cervical decompressions and fusions (PCDF).Results:Gu et al. also identified multiple risk factors for developing C5 palsies following posterior surgery; male gender, ossification of the posterior longitudinal ligament (OPLL), narrower foramina, laminectomy, and marked dorsal spinal cord drift. Miller et al. also identified an average $1918 increased cost for physical/occupational therapy for patients with C5 palsies.Conclusions:The incidence of C5 root deficits for anterior/posterior cervical surgery at C4-C5 was 12% in one series, and ranged up to 11.3% for laminectomies, while others cited 0–30%. Although identification of preoperative risk factors for C5 root deficits may help educate patients regarding these risks, there is no clear method for their avoidance at this time.
Highlights
Cervical C5 nerve root palsies may occur in between 0% and 30% of routine anterior or posterior cervical spine operations
The risk of C5 palsies occurring following anterior, posterior, or circumferential spine surgery varies from 0% to 30%.[3]
SNI: Spine 2015,Vol 6, Suppl 4 - A Supplement to Surgical Neurology International studies show no new focal lesion, most would recommend nonoperative management as the majority of deficits spontaneously resolve over 3–24 postoperative months
Summary
Different studies cite various frequencies for C5 root palsies following anterior or posterior cervical spine surgery. In their combined anterior/posterior series involving C4‐C5 level decompressions, Libelski et al cited up to a 12% incidence of C5 palsies. In Gu et al series, C5 root palsies occurred in 3.1% of double‐door laminoplasty, 4.5% of open‐door laminoplasty, and 11.3% of laminectomy. Miller et al observed an intermediate 6.9% frequency of C5 palsies followed by posterior cervical decompressions and fusions (PCDF)
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