Paralysis of the Arm Occurring After Decompression of the Cervical Spinal Cord

C5 Palsy after Decompression Surgery for Cervical Myelopathy

“…3,9,11,13,14,16,18,26,31,34 -37,40,43,44 The fact that the C5 root appears highly susceptible to injury may be related to the following three anatomic features of the cervical spine: 1) the zygapophysial joint at C4 -C5 protrudes more anteriorly than the other joints; 2) the rootlets and root of C5 are shorter than those of other segments 44,45 ; and 3) the C5 segment is usually the apex of the decompression area in laminoplasty and the extent of posterior shifting of the cord is thought to be greatest at the C5 level. 27,39,40,44 The extent of posterior shift of the spinal cord after laminoplasty was measured by various methods and reports indicate a 1 mm to 3 mm displacement. 24,40,46 -49 Yamashita et al reported that the posterior shift averaged 5 mm at C4 or C5 in patients with C5 palsy; this was significantly greater than in patients without clinical signs of palsy.…”