C5 Motor Palsy After Single- and Multi-level Anterior Cervical Diskectomy and Fusion: A Retrospective Review

Abstract

Introduction: Postoperative C5 nerve root palsy is a known complication after cervical surgery. The effect of increasing number of levels fused on the prevalence of C5 palsy after anterior cervical diskectomy and fusion (ACDF) is unclear. Methods: Medical records of ACDF patients that included the C4-5 level at one institution were retrospectively reviewed. C5 palsy was defined as motor decline of the deltoid and/or biceps brachii muscle function by at least 1 level on standard manual muscle testing. Results: A total of 196 patients met the inclusion criteria, with no significant differences noted between groups undergoing single- or multi-level ACDF. The overall C5 palsy rate was 5.1%. Palsy rates were not statistically significant based on the number of levels fused. Six of the 10 patients with C5 palsy had complete recovery of motor strength, whereas 2 patients had at least some level of strength recovery. Conclusion: The overall C5 palsy rate was 5.1% for all patients undergoing up to four-level ACDF. The rate of postoperative motor decline was lowest in the patients undergoing two-level ACDF and highest in the single-level group, but this finding did not reach statistical significance. The prognosis for strength recovery by final follow-up is excellent. Level of Evidence: Level III, Case-control

Prediction of the risk of C5 palsy after posterior laminectomy and fusion with cervical myelopathy using a support vector machine: an analysis of 184 consecutive patients

“…Abnormal electromyogram results indicated that the patient had subclinical nerve root compression, which was the pathological basis for the occurrence of C5P. Although numerous previous studies have shown that preoperative and postoperative JOA scores were not independent predictors of C5P, something interesting was observed in this study [32][33][34][35][36]. The JOA recovery rate was significantly higher in the C5P group than in the No C5P group and was identified as an independent risk factor for C5P.…”

Prediction of the Risk of C5 Palsy After Posterior Laminectomy and Fusion With Cervical Myelopathy Using Support Vector Machine: an Analysis of 184 Consecutive Patients

“…Although numerous previous studies have shown that preoperative, and postoperative JOA scores were not independent predictors of C5P, something interesting was observed in this study. [33][34][35][36][37] The JOA recovery rate was signi cantly higher in C5P group than that in the no-C5P group and was identi ed as an independent risk factor for C5P. In our clinical practice, the majority of patients with C5P had a good prognosis without speci c treatment.…”