Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep 16.
doi: 10.1227/neu.0000000000003704. Online ahead of print.

Incidence of C5 Palsy and Recovery Rate After Cervical Spine Surgery: A Systematic Review and Meta-Analysis

Isabelle G Stockman  1 , Mohamed A R Soliman  2   3   4 , Esteban Quiceno  2   3 , Alexander O Aguirre  2   3 , Mirza Baig  5 , Ayub Ansari  5 , Yazan Tanbour  5 , Amna Aslam  6 , Hannon W Levy  7 , Moleca M Ghannam  2   3 , Cathleen C Kuo  1 , Justin Im  1 , Evan Burns  1 , Evan M Sood  1 , Umar Masood  1 , Hendrick Francois  1 , Lauren C Levy  8 , Rehman Baig  2   9 , Asham Khan  2   3 , John Pollina  2   3 , Jeffrey P Mullin  2   3
Affiliations

Incidence of C5 Palsy and Recovery Rate After Cervical Spine Surgery: A Systematic Review and Meta-Analysis

Isabelle G Stockman et al. Neurosurgery. .

Abstract

Background and objectives: C5 nerve palsy is a debilitating complication of cervical spine surgery that can occur after certain approaches. To our knowledge, no previous systematic reviews have compared the rates of C5 nerve palsy after different cervical approaches, identifying the rate at which this complication becomes permanent. We aimed to compare the rates of C5 palsy after different cervical spine surgery approaches and the rates of recovery when C5 palsy was present.

Methods: A literature search of the PubMed and Embase databases from their inception to July 1, 2023, was completed to identify studies that focused on cervical spine surgery. Studies were excluded if they did not provide the rate of C5 palsy occurrence or define which surgical approaches were used. A pooled, weighted prevalence rate of C5 palsy was calculated for each approach, including the rate of permanent C5 palsy.

Results: A total of 155 studies met the inclusion criteria. Of these studies, 22 (14.2%) reported on laminectomies, 77 (49.7%) on laminoplasties, 38 (24.5%) on posterior cervical decompression and fusion, 39 (25.2%) on anterior cervical diskectomy and fusion, and 4 (2.6%) on corpectomies. Patients who had laminectomies had the highest incidence of C5 palsy at a pooled rate of 8%, of which 1.44% of cases were permanent. This was followed by posterior cervical decompression and fusion with a rate of 7.03% and a permanence rate of 1.02%. Patients receiving laminoplasties had a C5 palsy incidence of 5.11%; of these, 0.28% of cases were permanent. Patients who had corpectomies had an incidence of 4.16%; those who had anterior cervical diskectomy and fusions had the lowest incidence of 2.61%, of which 1.06% of cases were permanent.

Conclusion: C5 nerve palsy is a known complication after cervical spine surgeries, with increased rates in posterior approaches, although the rate of these complications becoming permanent is minimal.

Keywords: Anterior cervical diskectomy and fusion; C5 palsy; Laminectomy; Laminoplasty; Posterior cervical decompression and fusion; Postoperative complications; Recovery.

PubMed Disclaimer

References

    1. Neifert SN, Martini ML, Yuk F, et al. Predicting trends in cervical spinal surgery in the United States from 2020 to 2040. World Neurosurg. 2020;141:E175-E181.
    1. Ikenaga M, Shikata J, Tanaka C. Radiculopathy of C-5 after anterior decompression for cervical myelopathy. J Neurosurg Spine. 2005;3(3):210-217.
    1. Takase H, Haze T, Yamamoto D, et al. Network meta-analysis of C5 palsy after anterior cervical decompression of three to six levels: comparing three different procedures. Spine. 2024;49(3):188-196.
    1. Culler SD, McGuire KJ, Little KM, et al. Incremental hospital cost and length-of-stay associated with treating adverse events among medicare beneficiaries undergoing cervical spinal fusion during fiscal year 2013 and 2014. Spine. 2017;42(20):1578-1586.
    1. Goz V, Rane A, Abtahi AM, Lawrence BD, Brodke DS, Spiker WR. Geographic variations in the cost of spine surgery. Spine. 2015;40(17):1380-1389.

LinkOut - more resources