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Impact of the surgical strategy on the incidence of C5 nerve root palsy in decompressive cervical surgery

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  • Theresa Krätzig
  • Malte Mohme
  • Klaus C Mende
  • Sven O Eicker
  • Frank W Floeth

Abstract

Objective: Our aim was to identify the impact of different surgical strategies on the incidence of C5 palsy. Background: Degenerative cervical spinal stenosis is a steadily increasing morbidity in the ageing population. Postoperative C5 nerve root palsy is a common complication with severe impact on the patients´ quality of life. Methods: We identified 1708 consecutive patients who underwent cervical decompression surgery due to degenerative changes. The incidence of C5 palsy and surgical parameters including type and level of surgery were recorded to identify predictors for C5 nerve palsy. Results: The overall C5 palsy rate was 4.8%, with 18.3% of cases being bilateral. For ACDF alone the palsy rate was low (1.13%), compared to 14.0% of C5 palsy rate after corpectomy. The risk increased with extension of the procedures. Hybrid constructs with corpectomy plus ACDF at C3-6 showed significantly lower rates of C5 palsy (10.7%) than corpectomy of two vertebrae (p = 0.005). Multiple regression analysis identified corpectomy of C4 or C5 as a significant predictor. We observed a lower overall incidence for ventral (4.3%) compared to dorsal (10.9%) approaches (p

Suggested Citation

  • Theresa Krätzig & Malte Mohme & Klaus C Mende & Sven O Eicker & Frank W Floeth, 2017. "Impact of the surgical strategy on the incidence of C5 nerve root palsy in decompressive cervical surgery," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-14, November.
    • Handle: RePEc:plo:pone00:0188338
    DOI: 10.1371/journal.pone.0188338
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