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Published in: European Spine Journal 12/2015

01-12-2015 | Original Article

Delayed postoperative C5 root palsy and the use of neurophysiologic monitoring

Authors: Steven Spitz, Daniel Felbaum, Nima Aghdam, Faheem Sandhu

Published in: European Spine Journal | Issue 12/2015

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Abstract

Introduction

Although advances have been made in surgical technique and intraoperative monitoring, the rate of postoperative C5 palsy remains the same. We attempt to define characteristics which may predict risk of developing postoperative C5 palsy.

Methods

Retrospective chart review identified 644 patients undergoing cervical procedures. Anterior cervical discectomy and fusion was performed in 456, anterior cervical corpectomy and fusion (ACCF) in 78, posterior laminectomy and fusion (PLF) in 106, and posterior open-door laminoplasty in 4 patients. All patients had neurophysiologic monitoring [somatosensory-evoked potentials (SSEP), spontaneous electromyogram (EMG), and/or motor-evoked potential (MEP)].

Results

Postoperative C5 root palsy occurred in 5 (2 with ACCF and 3 with PLF) cases (1.4 %). In all cases, there were no changes in intraoperative neurophysiologic monitoring. C5 palsy did not occur before postoperative day 2.

Conclusions

Patients undergoing cervical decompression remain at risk for C5 root palsy despite use of monitoring. Given that all patients experienced delayed onset of C5 palsy, MEP, SSEP, and EMG may not be sensitive enough to assess the risk of developing C5 palsy.
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Metadata
Title
Delayed postoperative C5 root palsy and the use of neurophysiologic monitoring
Authors
Steven Spitz
Daniel Felbaum
Nima Aghdam
Faheem Sandhu
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 12/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-4252-z

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