C5 nerve root palsy after posterior cervical spine surgery

Area of Science:

• Neurosurgery
• Spinal Surgery
• Neurology

Background:

• C5 palsy is a significant complication following cervical decompression surgery, characterized by upper limb motor deficits.
• The exact pathogenesis and effective preventive strategies for C5 palsy remain unclear, despite various proposed hypotheses.

Purpose of the Study:

• To systematically review the clinical characteristics, risk factors, underlying mechanisms, and preventive measures associated with C5 palsy after posterior cervical decompression surgery.

Main Methods:

• A comprehensive literature search was conducted on PubMed for studies reporting on C5 palsy with over 10 cases.
• Data analysis was performed using Microsoft Excel, with statistical comparisons made where applicable.

Main Results:

• Twenty-eight studies met the inclusion criteria, revealing an average C5 palsy incidence of 7.8%.
• Identified risk factors include advanced age, male gender, ossification of the posterior longitudinal ligament, and C4-C5 intervertebral foramen stenosis.
• Foraminotomy and intraoperative neuromonitoring were highlighted as primary preventive techniques.

Conclusions:

• C5 palsy is an early-stage complication of cervical decompression surgery with a low incidence but significant impact on patient quality of life.
• While foraminotomy and neuromonitoring are key preventive strategies, risk factors and mechanisms are still debated.
• Conservative treatment generally yields good prognoses, but higher-quality research is needed for definitive conclusions.