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European Spine Journal

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01-04-2017 | Original Article

Clinical analysis of C5 palsy after cervical decompression surgery: relationship between recovery duration and clinical and radiological factors

Authors: Chae-Hong Lim, Sung-Woo Roh, Seung-Chul Rhim, Sang-Ryong Jeon

Published in: European Spine Journal | Issue 4/2017

Abstract

Background

Postoperative C5 palsy is a widely known complication of cervical decompression surgery. Many studies have focused on its etiology and factors affecting it. However, no study to date has evaluated the association between the clinical outcome and recovery duration of post-operative C5 palsy. We evaluated this in our current report.

Methods

A retrospective analysis was conducted for 710 consecutive degenerative cervical spine decompression surgeries performed in a single institution. We included all patients who underwent any type of surgical procedure for cervical spinal stenosis, ossification of posterior longitudinal ligament (OPLL), or cervical spondylotic myelopathy (CSM). Demographic, radiologic, clinical information was recorded. Finally, correlation analysis was conducted to identify demographic, radiologic, or clinical factors related with recovery duration (within or after 6 months).

Results

The incident rate of postoperative C5 palsy was 5.1 % (36/710 cases). Analysis of recovery duration revealed that 18 patients had recovered within 6 months and 33 (91.7 %) within 2 years, whilst 3 individuals (8.3 %) had not fully recovered within the follow-up period. Factors related to longer recovery (>6 months) included motor grade ≤2 (p < 0.001), presence of multi-segment paresis involving more than the C5 root (p = 0.002), loss of somatic sensation with pain (p = 0.008), and the degree of posterior spinal cord shifting (p = 0.040). Furthermore, multivariate analysis revealed that motor grade ≤2 (p = 0.010) had a significant effect on a recovery duration beyond 6 months.

Conclusions

A motor grade ≤2, the presence of multi-segment paresis involving more than the C5 root, the loss of somatic sensation with pain, and the degree of posterior spinal cord shifting significantly influence whether the duration of recovery from postoperative C5 palsy will take longer than 6 months.

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Title: Clinical analysis of C5 palsy after cervical decompression surgery: relationship between recovery duration and clinical and radiological factors
Authors: Chae-Hong Lim
Sung-Woo Roh
Seung-Chul Rhim
Sang-Ryong Jeon
Publication date: 01-04-2017
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 4/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-016-4664-4

At a glance: The STEP trials

Springer Medicine

Clinical analysis of C5 palsy after cervical decompression surgery: relationship between recovery duration and clinical and radiological factors

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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