C5 Palsy After Cervical Decompression: A 10-Year Single-Institution Study Highlighting Early Onset, High...

Area of Science:

• Neurosurgery
• Spinal Surgery
• Neurology

Background:

• C5 palsy, a complication of cervical decompression, causes deltoid/biceps weakness.
• Mechanisms are debated, including root traction, stenosis, and ischemia-reperfusion injury.
• Incidence and recovery vary, highlighting the need for institutional data.

Purpose of the Study:

• Evaluate the incidence, characteristics, and outcomes of C5 palsy.
• Identify unique patterns in a 10-year patient cohort.
• Compare findings with existing literature on severity and bilaterality.

Main Methods:

• Retrospective observational study of cervical decompression patients over 10 years.
• Assessed incidence, onset timing, laterality, surgical approach, and neurological outcomes.
• Focused on identifying differences from prior studies, especially regarding severity and bilaterality.

Main Results:

• 14 of 198 patients (7.1%) developed C5 palsy with universal early onset.
• Unusually high bilateral involvement (35.7%).
• Poor recovery: 57.1% persistent deficits, 21.4% worsened, only 21.4% improved, none fully recovered. Posterior approaches (71.4%) and foraminal stenosis (35.7%) were noted.

Conclusions:

• C5 palsy in this cohort exhibited early onset, high bilaterality, and poor recovery.
• Suggests multifactorial causes beyond isolated root traction.
• Posterior approaches and foraminal stenosis are significant risk factors; improved prevention and surgical techniques are recommended.