The incidence of C5-C6 radiculopathy as a complication of extensive cervical decompression: own results and review of literature

Abstract

This retrospective study aims to discuss and compare our results with those previously mentioned in the literature with regard to C5-C6 radiculopathy that occurs after decompression carried out for cervical spondylotic myelopathy. There are few reports in the literature referring to the incidence of the C5-C6 radiculopathy following cervical decompression procedures. Some authors believe that the postoperative cord shift is the most likely cause. From January 1994 to November 2002, 121 patients underwent cervical corpectomies for cervical spondylotic myelopathy. The preoperative and the postoperatively discovered paresis have been assessed according to the criteria of the British Medical Council. The Nurick Scale was used to grade the severity of the myelopathic changes. The follow-up period varied from 4 to 111 months with an average of 50 months. Symptoms of C5 and/or C6 radiculopathy appeared in 10 patients (8.2%) postoperatively. Aggravation of a preoperative C5 and/or C6 radiculopathy was seen in 3 patients, while 7 patients developed a new C5 and/or C6 radiculopathy in the immediate postoperative period. These motor deficits resolved completely in 7 patients within 7 months of surgery, whereas a residual motor weakness remained in the other 3 patients. The postoperative C5 motor deficit is not infrequently associated with partial involvement of the C6 root. The lesions can be either unilateral or bilateral with a statistically average frequency of 8%. The prognosis is generally favorable. Our results did not support the hypothesis that the claimed cord shift phenomenon is a possible aetiology.