[C5 palsy after multi-segmental cervical decompression : How can it be avoided?]

Anterior cervical discectomy and fusion (ACDF) as well as posterior instrumentation of the cervical spine are frequently performed surgeries for cervical disc prolapse or spinal stenosis. Surgery itself harbors a very low risk of adverse events. Postoperative palsy of the C5 nerve root, however, is a severe complication and its origin is still not fully understood. The risk of such a C5 palsy is reported to be between 0 and 30%; 5% on average according to the literature.

To describe underlying pathomechanisms and to recommend strategies for risk reduction.

An extensive literature research via Medline was performed.

Potential risk factors are male gender, sagittal diameter below 5.6 mm, anterior approach, and higher age.

Currently available data only originates from retrospective or anatomical studies. A prospective register study with the goal to put light on the pathogenesis is currently being performed.