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Predicting Postoperative C5 Palsy Using Preoperative Spinal Cord Rotation.

A Jessey Chugh, Jeremy J Gebhart, Jason D Eubanks

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    Preoperative spinal cord rotation can predict C5 nerve palsy after cervical decompression surgery. Mild rotation (<6°) showed a lower risk, while severe rotation (>10°) indicated a higher likelihood of developing C5 palsy.

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    Area of Science:

    • Neurosurgery
    • Spinal Surgery
    • Orthopedic Surgery

    Background:

    • C5 nerve palsy is a known complication following cervical decompression surgery.
    • Identifying predictive factors for C5 palsy is crucial for patient management.

    Purpose of the Study:

    • To investigate if preoperative spinal cord rotation predicts C5 nerve palsy after posterior cervical decompression at C4-C6.
    • To compare spinal cord parameters between anterior and posterior decompression groups.

    Main Methods:

    • Retrospective review of 72 posterior and 77 anterior cervical decompression cases.
    • Analysis of MRI scans for spinal cord area, diameter, and rotation relative to vertebral bodies.
    • Statistical correlation analysis between spinal cord rotation and C5 palsy incidence.

    Main Results:

    • The overall incidence of C5 palsy was 7.3%.
    • Significant association found between spinal cord rotation degree and C5 palsy (r=0.58-0.60, P<.001).
    • A 6° rotation cutoff demonstrated high specificity (0.95) for predicting C5 palsy in the posterior group.

    Conclusions:

    • Preoperative spinal cord rotation is a potential predictor of C5 nerve palsy after posterior cervical decompression.
    • Increased spinal cord rotation correlates with a higher risk of developing C5 palsy.
    • Rotation thresholds (mild <6°, moderate 6°-10°, severe >10°) showed varying C5 palsy prevalence.