title: C5 nerve root palsy following decompression of the cervical spine: a systematic evaluation of the literature.
abstract: C5 nerve root palsy is a rare and potentially debilitating complication of cervical spine surgery. Currently, however, there are no guidelines to help surgeons to prevent or treat this complication. We carried out a systematic review of the literature to identify the causes of this complication and options for its prevention and treatment. Searches of PubMed, Embase and Medline yielded 60 articles for inclusion, most of which addressed C5 palsy as a complication of surgery. Although many possible causes were given, most authors supported posterior migration of the spinal cord with tethering of the nerve root as being the most likely. Early detection and prevention of a C5 nerve root palsy using neurophysiological monitoring and variations in surgical technique show promise by allowing surgeons to minimise or prevent the incidence of C5 palsy. Conservative treatment is the current treatment of choice; most patients make a full recovery within two years.
authors.affiliation: Icahn School of Medicine at Mount Sinai, Leni & Peter W. May Department of Orthopaedic Surgery, 5 E. 98th Street, Box 1188, New York, New York 10029, USA.
authors.forename: J Z
authors.initials: JZ
authors.lastname: Guzman
authors.affiliation: Icahn School of Medicine at Mount Sinai, Leni & Peter W. May Department of Orthopaedic Surgery, 5 E. 98th Street, Box 1188, New York, New York 10029, USA.
authors.forename: E O
authors.initials: EO
authors.lastname: Baird
authors.affiliation: Icahn School of Medicine at Mount Sinai, Leni & Peter W. May Department of Orthopaedic Surgery, 5 E. 98th Street, Box 1188, New York, New York 10029, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Fields
authors.affiliation: Icahn School of Medicine at Mount Sinai, Leni & Peter W. May Department of Orthopaedic Surgery, 5 E. 98th Street, Box 1188, New York, New York 10029, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: McAnany
authors.affiliation: Icahn School of Medicine at Mount Sinai, Leni & Peter W. May Department of Orthopaedic Surgery, 5 E. 98th Street, Box 1188, New York, New York 10029, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Qureshi
authors.affiliation: Icahn School of Medicine at Mount Sinai, Leni & Peter W. May Department of Orthopaedic Surgery, 5 E. 98th Street, Box 1188, New York, New York 10029, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Hecht
authors.affiliation: Icahn School of Medicine at Mount Sinai, Leni & Peter W. May Department of Orthopaedic Surgery, 5 E. 98th Street, Box 1188, New York, New York 10029, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Cho
mesh_terms: D020516:Brachial Plexus Neuropathies / Q000453:epidemiology* / Q000517:prevention & control; D002574:Cervical Vertebrae / Q000293:injuries*; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D064795:Intraoperative Neurophysiological Monitoring; D007796:Laminectomy / Q000009:adverse effects; D008297:Male; D017887:Ossification of Posterior Longitudinal Ligament / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D013126:Spinal Nerve Roots / Q000293:injuries*
keywords: C5 palsy; Cervical Surgery Complications; Neuromonitoring; Posterior Drift; Postoperative