C5 palsy after cervical laminoplasty: a multicentre study.
We have reviewed 1858 patients who had undergone a cervical laminoplasty and identified 43 (2.3%) who had developed a C5 palsy with a MMT (MRC) grade of 0 to 2 in the deltoid, with or without involvement of the biceps, but with no loss of muscular strength in any other muscles. The clinical features and radiological findings of patients with (group P; 43 patients) and without (group C; 100 patients) C5 palsy were compared. CT scanning of group P revealed a significant narrowing of the intervertebral foramen of C5 (p < 0.005) and a larger superior articular process (p < 0.05). On MRI, the posterior shift of the spinal cord at C4-5 was significantly greater in group P, than in group C (p < 0.01). This study is the first to correlate impairment of the C5 nerve root with a C5 palsy. It may be that early foraminotomy in susceptible individuals and the avoidance of tethering of the cord by excessive laminoplasty may prevent a post-operative palsy of the C5 nerve root.
Imagama
S
S
Department of Orthopaedic Surgery, Nagoyal University Graduate School of Medicine, 65 Turumai, Showa-ku, Nagoya 466-8550, Japan. Imagama@med.nagoya-u.ac.jp
Matsuyama
Y
Y
Yukawa
Y
Y
Kawakami
N
N
Kamiya
M
M
Kanemura
T
T
Ishiguro
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020516:Brachial Plexus Neuropathies / Q000209:etiology; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology; D010243:Paralysis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D012720:Severity of Illness Index; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed