Does Prophylactic Foraminotomy Reduce Postoperative C5 Palsy in Posterior Reconstruction Surgery Using Cervical...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Postoperative C5 nerve palsy is a known complication of posterior cervical decompression and reconstruction.
• The exact mechanism of C5 palsy remains unclear, and the effectiveness of prophylactic C4-5 foraminotomy is debated.

Purpose of the Study:

• To evaluate the effectiveness of prophylactic C4-5 foraminotomy in preventing postoperative C5 nerve palsy.
• To identify risk factors associated with C5 palsy following cervical pedicle screw (CPS)-based corrective surgery.

Main Methods:

• Retrospective analysis of 37 patients undergoing CPS-based corrective surgery.
• Comparison of radiographic parameters between patients with and without postoperative C5 palsy.
• Evaluation of prophylactic foraminotomy's effect using Fisher's exact test and logistic regression.

Main Results:

• No significant difference in C5 palsy incidence was found between foramina with and without prophylactic foraminotomy.
• Greater C4-5 correction angles and smaller preoperative foraminal diameters were associated with C5 palsy.
• Mean recovery time for C5 palsy was 2.6 months, with most cases being transient.

Conclusions:

• Prophylactic C4-5 foraminotomy is not effective in reducing C5 palsy after CPS surgery.
• Greater correction angles and preoperative foraminal stenosis are risk factors for C5 palsy.
• C5 palsy following CPS surgery is typically transient, with a favorable recovery outlook.