Radiographic Measures of Spinal Alignment Are Not Predictive of the Development of C5 Palsy Following Anterior Cervical Discectomy and Fusion Surgery

Overview

Journal Int J Spine Surg

Date 2021 Apr 26

PMID 33900977

Citations 1

Authors

Andrew M Sinensky

Ian D Kaye

William T Li

Scott C Wagner

Joseph S Butler

Arjun S Sebastian

Patrick B Morrissey

Gregory D Schroeder

Christopher Kepler

Alexander R Vaccaro

Alan S Hilibrand

Affiliations

Soon will be listed here.

Abstract

Background: Postoperative C5 palsy is a common complication following cervical decompression, occurring more frequently after posterior-based procedures. It has been theorized that this is the result of C5 nerve stretch resulting from spinal cord drift with these procedures. As such, it is thought to be less common after anterior cervical decompression and fusion (ACDF). However, no consensus has been reached on its true etiology. The purpose of this study is to assess the rate of C5 palsy following ACDF and to determine whether any radiographic or demographic parameters were predictive of its development.

Methods: Two hundred and twenty-six patients who received ACDF between September 2015 and September 2016 were reviewed, and 122 were included in the final analysis. Patient demographic, surgical, and radiographic data were analyzed, including preoperative and postoperative radiographic and motor examination results. The Mann-Whitney test was used to compare continuous variables between independent groups, and Fisher's exact test was used to compare categorical variables between groups.

Results: Seven patients developed a C5 palsy in the postoperative period, an incidence rate of 5.7%. Among the radiographic parameters evaluated, there were no statistically significant differences between the C5 palsy and nonpalsy groups. Additionally, there were no statistically significant differences in age, patient sex, or numbers of vertebral levels fused between groups.

Conclusions: Ultimately, we did not identify any statistically significant demographic or radiographic predictive factors for the development of C5 palsy following ACDF surgery.

Level Of Evidence: 3.

Citing Articles

A systematic review of risk factors and adverse outcomes associated with anterior cervical discectomy and fusion surgery over the past decade.

Rai V, Sharma V, Kumar M, Thakur L J Craniovertebr Junction Spine. 2024; 15(2):141-152.

PMID: 38957769 PMC: 11216642. DOI: 10.4103/jcvjs.jcvjs_168_23.

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