Post-cervical decompression parsonage-turner syndrome represents a subset of C5 palsy: six cases and a review of the literature: case report.
BACKGROUND
Approximately 5% of cervical decompression cases are complicated by postoperative weakness. Parsonage-Turner syndrome (PTS) or neuralgic amyotrophy is known to be precipitated by surgery and unrelated to technical or structural issues. Our practice has seen a number of cases of PTS after cervical decompression surgery. In this case report, we discuss a series of such patients, highlighting the commonalities with the more frequently diagnosed C5 palsy. We conclude with our management algorithm.


METHODS
Six patients with post-cervical decompression PTS were referred to our institution during a 32-month period. All patients were examined physically, radiographically, and electromyographically and were followed for up to 2 years or until symptoms resolved. Conservative management was the rule, and surgical intervention, including nerve releases and nerve reconstruction, was undertaken in select circumstances. In the majority of patients (4 of 6 patients), pain management and physical therapy alone were used and achieved eventual resolution of pain and recovery of motor strength. The other 2 patients required adjunctive surgical procedures to maximize their outcomes.


CONCLUSIONS
PTS accounts for a subset of patients experiencing postoperative weakness after cervical decompression operations. Although it is at times difficult to arrive at this diagnosis, an understanding of the history of PTS, among other causes of postoperative weakness, allows a structured approach to these patients. An evidence-based approach to management helps provide the best outcome for a given patient.
Department of Neurological Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri 63110-1093, USA. brownjm@nsurg.wustl.edu
Justin M
JM
Brown
Andrew
A
Yee
Renee A
RA
Ivens
William
W
Dribben
Susan E
SE
Mackinnon
D000328:Adult; D000368:Aged; D020968:Brachial Plexus Neuritis / Q000209:etiology*; D019299:Decompression, Surgical / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013118:Spinal Cord Diseases / Q000601:surgery*