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Article: C5 nerve root palsy after cervical laminoplasty and posterior fusion with instrumentation

TitleC5 nerve root palsy after cervical laminoplasty and posterior fusion with instrumentation
Authors
KeywordsCervical Myelopathy
Laminoplasty
Postoperative C5 Palsy
Spinal Instrumentation
Surgical Complication
Issue Date2008
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.jspinaldisorders-tech.com
Citation
Journal Of Spinal Disorders And Techniques, 2008, v. 21 n. 4, p. 267-272 How to Cite?
AbstractStudy Design: Consecutive case series. Objective: To compare the incidence and clinical characteristics of postoperative fifth cervical nerve root palsy (C5 palsy) in patients with cervical myelopathy treated by laminoplasty alone and laminoplasty with posterior instrumentation. Summary of Background Data: In patients who have multilevel cervical myelopathy with reducible kyphosis or instability, the authors have performed laminoplasty together with instrumented fusion to restore lordosis and stability. There seems to be a high incidence of postoperative C5 palsy in these patients. Methods: Seventy-three patients with a mean age of 60.5 years and multilevel cervical myelopathy treated by laminoplasty from 1995 to 2005 were reviewed. Incidence, side, and severity of muscle weakness from patients with C5 palsy after posterior instrumented fusion (instrumented group) was compared with those without instrumentation (noninstrumented group). Radiologic parameters were assessed to identify predisposing factors. Results: Overall 10 of 73 (14%) patients developed the C5 palsy, of which 5 (50%) of 10 patients were in instrumented group, and 5 of 63 (8%) patients were in noninstrumented. Three of 5 (60%) had the palsy on the same side of the opened lamina in the instrumented group, in the same proportion as the noninstrumented. Three (60%) patients in instrumented group developed deltoid weakness grade 1, but none in the noninstrumented had weaker than grade 3. All of the palsied in the instrumented group recovered within 2 years after surgery without removal of implant. Of the 5 patients with the palsy in the instrumented group, 3 had anterolisthesis before surgery and posterior translation of C4 on C5 by the surgery, and no patient without the palsy had the anterolisthesis. Conclusions: Posterior cervical fusion using instrumentation for restoration of lordotic alignment combined with laminoplasty is highly associated with severe postoperative C5 palsy in patients with multilevel cervical myelopathy and C4 anterolisthesis. © 2008 by Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/170130
ISSN
2015 Impact Factor: 2.291
2015 SCImago Journal Rankings: 0.798
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTakemitsu, Men_US
dc.contributor.authorCheung, KMCen_US
dc.contributor.authorWong, YWen_US
dc.contributor.authorCheung, WYen_US
dc.contributor.authorLuk, KDKen_US
dc.date.accessioned2012-10-30T06:05:29Z-
dc.date.available2012-10-30T06:05:29Z-
dc.date.issued2008en_US
dc.identifier.citationJournal Of Spinal Disorders And Techniques, 2008, v. 21 n. 4, p. 267-272en_US
dc.identifier.issn1536-0652en_US
dc.identifier.urihttp://hdl.handle.net/10722/170130-
dc.description.abstractStudy Design: Consecutive case series. Objective: To compare the incidence and clinical characteristics of postoperative fifth cervical nerve root palsy (C5 palsy) in patients with cervical myelopathy treated by laminoplasty alone and laminoplasty with posterior instrumentation. Summary of Background Data: In patients who have multilevel cervical myelopathy with reducible kyphosis or instability, the authors have performed laminoplasty together with instrumented fusion to restore lordosis and stability. There seems to be a high incidence of postoperative C5 palsy in these patients. Methods: Seventy-three patients with a mean age of 60.5 years and multilevel cervical myelopathy treated by laminoplasty from 1995 to 2005 were reviewed. Incidence, side, and severity of muscle weakness from patients with C5 palsy after posterior instrumented fusion (instrumented group) was compared with those without instrumentation (noninstrumented group). Radiologic parameters were assessed to identify predisposing factors. Results: Overall 10 of 73 (14%) patients developed the C5 palsy, of which 5 (50%) of 10 patients were in instrumented group, and 5 of 63 (8%) patients were in noninstrumented. Three of 5 (60%) had the palsy on the same side of the opened lamina in the instrumented group, in the same proportion as the noninstrumented. Three (60%) patients in instrumented group developed deltoid weakness grade 1, but none in the noninstrumented had weaker than grade 3. All of the palsied in the instrumented group recovered within 2 years after surgery without removal of implant. Of the 5 patients with the palsy in the instrumented group, 3 had anterolisthesis before surgery and posterior translation of C4 on C5 by the surgery, and no patient without the palsy had the anterolisthesis. Conclusions: Posterior cervical fusion using instrumentation for restoration of lordotic alignment combined with laminoplasty is highly associated with severe postoperative C5 palsy in patients with multilevel cervical myelopathy and C4 anterolisthesis. © 2008 by Lippincott Williams & Wilkins.en_US
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.jspinaldisorders-tech.comen_US
dc.relation.ispartofJournal of Spinal Disorders and Techniquesen_US
dc.rightsJournal of Spinal Disorders & Techniques. Copyright © Lippincott Williams & Wilkins.-
dc.subjectCervical Myelopathyen_US
dc.subjectLaminoplastyen_US
dc.subjectPostoperative C5 Palsyen_US
dc.subjectSpinal Instrumentationen_US
dc.subjectSurgical Complicationen_US
dc.titleC5 nerve root palsy after cervical laminoplasty and posterior fusion with instrumentationen_US
dc.typeArticleen_US
dc.identifier.emailCheung, KMC:cheungmc@hku.hken_US
dc.identifier.emailLuk, KDK:hcm21000@hku.hken_US
dc.identifier.authorityCheung, KMC=rp00387en_US
dc.identifier.authorityLuk, KDK=rp00333en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1097/BSD.0b013e31812f6f54en_US
dc.identifier.pmid18525487-
dc.identifier.scopuseid_2-s2.0-48949104324en_US
dc.identifier.hkuros145966-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-48949104324&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume21en_US
dc.identifier.issue4en_US
dc.identifier.spage267en_US
dc.identifier.epage272en_US
dc.identifier.isiWOS:000256742500007-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridTakemitsu, M=6701368051en_US
dc.identifier.scopusauthoridCheung, KMC=7402406754en_US
dc.identifier.scopusauthoridWong, YW=34882411200en_US
dc.identifier.scopusauthoridCheung, WY=24504264600en_US
dc.identifier.scopusauthoridLuk, KDK=7201921573en_US

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