title: C5 Nerve root palsies following cervical spine surgery: A review.
abstract: BACKGROUND
  Cervical C5 nerve root palsies may occur in between 0% and 30% of routine anterior or posterior cervical spine operations. They are largely attributed to traction injuries/increased cord migration following anterior/posterior decompressions. Of interest, almost all studies cite spontaneous resolution of these deficits without surgery with 3-24 postoperative months.
  
  
  METHODS
  Different studies cite various frequencies for C5 root palsies following anterior or posterior cervical spine surgery. In their combined anterior/posterior series involving C4-C5 level decompressions, Libelski et al. cited up to a 12% incidence of C5 palsies. In Gu et al. series, C5 root palsies occurred in 3.1% of double-door laminoplasty, 4.5% of open-door laminoplasty, and 11.3% of laminectomy. Miller et al. observed an intermediate 6.9% frequency of C5 palsies followed by posterior cervical decompressions and fusions (PCDF).
  
  
  RESULTS
  Gu et al. also identified multiple risk factors for developing C5 palsies following posterior surgery; male gender, ossification of the posterior longitudinal ligament (OPLL), narrower foramina, laminectomy, and marked dorsal spinal cord drift. Miller et al. also identified an average $1918 increased cost for physical/occupational therapy for patients with C5 palsies.
  
  
  CONCLUSIONS
  The incidence of C5 root deficits for anterior/posterior cervical surgery at C4-C5 was 12% in one series, and ranged up to 11.3% for laminectomies, while others cited 0-30%. Although identification of preoperative risk factors for C5 root deficits may help educate patients regarding these risks, there is no clear method for their avoidance at this time.
authors.affiliation: Department of NeuroScience, Winthrop University Hospital, Mineola, NY 11501, USA.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Epstein
authors.affiliation: Department of NeuroScience, Winthrop University Hospital, Mineola, NY 11501, USA.
authors.forename: Renee
authors.initials: R
authors.lastname: Hollingsworth
keywords: Anterior surgery; C4-C5 surgery; C5 root palsies; cervical; factors; posterior surgery; risk