The Association Between Preoperative Spinal Cord Rotation and Postoperative C5 Nerve Palsy

Abstract

Our evidence suggests that spinal cord rotation is a strong and significant predictor of C5 palsy postoperatively. Patients can be classified into three types, with Type 1 representing mild rotation (0° to 5°), Type 2 representing moderate rotation (6° to 10°), and Type 3 representing severe rotation (≥ 11°). The rate of C5 palsy was zero of 159 in the Type-1 group, eight of thirteen in the Type-2 group, and four of four in the Type-3 group. This information may be valuable for surgeons and patients considering anterior surgery in the C4 to C6 levels.

C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases

“…33 Eskander et al defined it as MMT score of ≤3 on a scale of 5. 28 Hasegawa et al defined C5 palsy as deterioration of motor function by at least 1 level in a standard MMT of the deltoid and/or bicep without aggravation of lower extremity function, the appearance of a new sensory disturbance between postoperative day 0 and 2 months after surgery, or both deterioration of motor function and the appearance of a new sensory disturbance. 23 …”

“…The incidence of this complication has been reported to be between 0% and 30% depending on procedure type and approach. 1-36 Patients commonly present with new weakness in the deltoid and/or biceps brachii, sensory deficits, and/or pain in the shoulders, and dissatisfaction with surgery *. C5 palsy may present immediately after surgery or up to 2 months postoperatively † and can negatively affect postoperative quality of life in the short term.…”

C5 nerve root palsy after posterior cervical spine surgery

“…Most patients experienced palsy of the deltoid muscle in the early postoperative stage, with symptoms subsiding gradually. [15][16][17][18] However, a palsy with MMT 2 was sometimes irreversible, 19 and often decreased patients' quality of life and put a burden on their financial status by delaying their return to work after surgery. 18,20 The method employed to diagnose C5 palsy was the MMT, which divides the strength of the muscle into six grades from 0 to 5.…”

Bilateral C5 Motor Palsy after Anterior Cervical Decompression and Fusion: A Case Report and Review of the Literature

“…[10][11][12][13] Although relatively rare, the economic and psychosocial cost of a postoperative C5 palsy is significant. Patients with unilateral postoperative C5 palsy have demonstrated reduced ability for self-care, reduced quality of life, and have incurred increased medical costs due to the need for outpatient physical and occupational therapy.…”