C5 Palsy Following Cervical Spine Decompression

Background: Cervical spinal surgery is considered safe and effective. One of the few specific complications of this procedure is C5 nerve root patsy. Expressed primarily by deltoid muscle and biceps brachii weakness, it is rare and has been related to nerve root traction or to ischemic spinal cord damage. Objectives: To determine the clinical and epidemiological traits of C5 palsy. To determine whether C5 patsy occurs predominantly in one specific surgical approach compared to others. Methods: A retrospective study of patients who underwent cervical spine surgery at our medical center during a consecutive 8-year period was conducted. The patient data were analyzed for demographics, diagnosis, and surgery type and approach, as well as for complications, with emphasis on the C5 nerve root patsy. Results: The study group was comprised of 124 patients. Seven (5.6%) developed a C5 palsy following surgery. Interventions were either by anterior, by posterior or by a combined approach. Seven patients developed this complication. AU of whom had myelopathy and were older males. A combined anteroposterior (5 patients) and posterior access (2 patients) were the only approaches that were associated with the C5 patsy. None of the patients who were operated via an anterior approach did develop this sequel. Conclusions: The incidence of the C5 root patsy in our cohort reached 5.6%. interventions performed through a combined anterior-posterior access in older myetopathic mates, may carry the highest risk for this complication.