C5 palsy after C5/6/7 posterior foraminal decompression: A case report.

Area of Science:

• Neurosurgery
• Spinal Surgery
• Cervical Spine Disorders

Background:

• C5 palsy is a known complication of cervical spine surgery, but its exact cause remains unclear.
• Prophylactic foraminotomy is sometimes used to prevent C5 palsy, though its efficacy and mechanism are debated.

Observation:

• A 43-year-old male developed C5 palsy post-microendoscopic foraminotomy at the C5/6/7 levels for radiculopathy.
• Postoperatively, the patient exhibited weakness in the left deltoid, biceps, and forearm pronator muscles.

Findings:

• The patient experienced complete motor strength recovery within three months.
• The C5 palsy in this case was not explained by direct nerve root impingement or circulatory compromise.

Implications:

• This case suggests drill heat or anatomical variations in the brachial plexus may contribute to C5 palsy after foraminotomy.
• Prophylactic foraminotomy should be approached with caution, especially in patients potentially at risk for C5 palsy, as it can paradoxically cause the condition.