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

Abstract

Background: 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.

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

Materials and methods: An extensive literature research via Medline was performed.

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

Conclusions: 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.

Keywords: Cervical vertebrae; Complication, postoperative; Disc prolapse; Paralysis; Spinal stenosis.