Neurospine

Original Article

Epidemiology of C5 Palsy after Cervical Spine Surgery: A 21-Center Study: Jae Keun Oh, Jae Taek Hong, Dong Ho Kang, Sang-Woo Kim, Seok Won Kim, Young Jin Kim, Chun Kee Chung, Jun Jae Shin, Seong Yi, Jung Kil Lee, Jun Ho Lee, Chang-Hyun Lee, Ho Jin Lee, Hyoung-Joon Chun, Dae-Chul Cho, Yong Eun Cho, Yong Jun Jin, Kyung-Chul Choi, In Ho Han, Seung-Jae Hyun, Jung-Woo Hur, Ki-Jeong Kim; Neurospine 2019;16(3):558-562. Published online September 30, 2019; DOI: https://doi.org/10.14245/ns.1938142.071

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Epidemiology of C5 Palsy after Cervical Spine Surgery: A 21-Center Study

Neurospine. 2019;16(3):558-562. Published online September 30, 2019

DOI: https://doi.org/10.14245/ns.1938142.071

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Epidemiology of C5 Palsy after Cervical Spine Surgery: A 21-Center Study

Neurospine. 2019;16(3):558-562. Published online September 30, 2019

DOI: https://doi.org/10.14245/ns.1938142.071

Objective
C5 palsy is a severe complication after cervical spine surgery, the pathophysiology of which remains unclear. This multicenter study investigated the incidence of C5 palsy following cervical spine surgery in Korea.
Methods
We conducted a retrospective multicenter study involving 21 centers from the Korean Cervical Spine Study Group. The inclusion criteria were cervical spine surgery patients between 2012 and 2016, excluding cases of neck surgery. In patients with C5 palsy, the operative methods, disease category, onset time of C5 palsy, recovery time, C5 manual muscle testing (MMT) grade, and post-C5 palsy management were analyzed.
Results
We collected 15,097 cervical spine surgery cases from 21 centers. C5 palsy occurred in 88 cases (0.58%). C5 palsy was more common in male patients (p=0.019) and after posterior approach procedures (p<0.001). C5 palsy usually occurred within 3 days after surgery (77 of 88, 87.5%) and most C5 palsy patients recovered within 6 months (51 of 88, 57.95%). Thirty C5 palsy patients (34.09%) had motor weakness, with an MMT grade≤2. Only four C5 palsy patients (4.5%) did not recover during follow-up. Posterior cervical foraminotomy was performed in 7 cases (7.95%), and steroids were used in 56 cases (63.63%). Twenty-six cases (29.55%) underwent close observation only.
Conclusion
The overall incidence of C5 palsy was relatively low (0.58%). C5 palsy was more common after posterior cervical surgery and in male patients. C5 palsy usually developed within 3 days after surgery, and more than half of patients with C5 palsy recovered within 6 months.

Citations

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Case Report

Long-term Sequela of Intradural Extramedullary Tuberculoma in the Thoracic Dorsal Spinal Cord: Case Report and Review of the Literature: Seil Sohn, Yong Jun Jin, Ki-Jeong Kim, Hyun-Jib Kim; Korean J Spine 2011;8(4):295-299. Published online December 31, 2011; DOI: https://doi.org/10.14245/kjs.2011.8.4.295

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Long-term Sequela of Intradural Extramedullary Tuberculoma in the Thoracic Dorsal Spinal Cord: Case Report and Review of the Literature

Korean J Spine. 2011;8(4):295-299. Published online December 31, 2011

DOI: https://doi.org/10.14245/kjs.2011.8.4.295

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Long-term Sequela of Intradural Extramedullary Tuberculoma in the Thoracic Dorsal Spinal Cord: Case Report and Review of the Literature

Korean J Spine. 2011;8(4):295-299. Published online December 31, 2011

DOI: https://doi.org/10.14245/kjs.2011.8.4.295

A 45-year old man, who had tuberculosis five years ago presented with paresthesia, decreased proprioception, and gait disturbance in the lower extremity which were aggravated for a month. Magnetic resonance imaging revealed the T3-7 intradural extramedullary fibrotic mass with dark signal intensity on T2-weighted images. The yellowish material in the thick fibrous mass was confirmed as caseous necrosis. Two days after the operation, the symptoms improved. Although quite rare, intradural extramedullary tuberculoma should be considered as a chronic sequel of the previous medical history of pulmonary tuberculosis or tuberculous meningitis.

Citations

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Intradural extramedullary tuberculoma in a case of disseminated tuberculosis: A case report
Chitranshu Shrivastava, Tushar Narayan Rathod, Rushikesh Bhanudas Shahade, Akshay Vasant Mohite, Bhushan Sunil Hadole, Deepika Jain
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Asian Journal of Neurosurgery.2018; 13(03): 928. CrossRef
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Korean Journal of Spine.2015; 12(2): 107. CrossRef

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Review

Cervical Intervertebral Disc Arthroplasty: Update.: Ki Jeong Kim, Sang Hoon Yoon, Yong Jun Jin, Sang Ki Chung, Hyun Jib Kim; Korean J Spine 2009;6(2):51-60.

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Cervical Intervertebral Disc Arthroplasty: Update.

Korean J Spine. 2009;6(2):51-60.

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Cervical Intervertebral Disc Arthroplasty: Update.

Korean J Spine. 2009;6(2):51-60.

Since 1966 the first metal ball shape implant was inserted into the cervical and lumbar areas by Dr. Fernstrom, numerous attempts and prostheses have been tried to maintain physiologic range of motion and prevent adjacent segment degeneration (ASD) after surgery. However fusion itself is not a single causative factor of ASD and other biologic factors including natural progression of degenerative process and mechanical factors also contribute in the development of ASD. Several well designed prospective randomized control studies for Bryan disc and Prodisc C have been recently documented preservation of spinal motion, superior or, at least, equivalent clinical outcome in comparing with anterior cervical arthrodesis, and less adverse postoperative events both in frequency and severity. Still remained or undetermined problems in cervical arthroplasty are heterotopic ossifications, segmental kyphosis of implanted levels, MR imaging compatibility, vertebral body fracture by keeled prostheses and long term wear properties. In spite of these unsolved problems and incompleteness of prosthetic design, cervical arthroplasty is now considered as one of standard methods in surgical management of one or two level cervical disc diseases and its indication may be broader in near future.

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Case Report

Eosinophilic Granuloma in an Adult Thoracic Spine: A Case Report.: Jeong Gyun Kim, Wook Ha Kim, Sang Hoon Yoon, Yong Jun Jin, Ki Jeong Kim, Hyun Jib Kim; Korean J Spine 2010;7(3):177-179.

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Eosinophilic Granuloma in an Adult Thoracic Spine: A Case Report.

Korean J Spine. 2010;7(3):177-179.

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Eosinophilic Granuloma in an Adult Thoracic Spine: A Case Report.

Korean J Spine. 2010;7(3):177-179.

In adults, eosinophilic granuloma of the spine is a rare, benign osteolytic lesion. In a case of a 33-year-old man with neurologic deterioration, magnetic resonance imaging (MRI) showed an osteolytic lesion of the T4 vertebra with spinal cord compression. Involvement of the left pedicle of T4 and paravertebral soft tissue was also observed. On the second day after a fluoroscopic percutaneous needle biopsy, the patient abruptly developed paraplegia. He underwent an emer- gency operation with posterior decompression, followed by anterior stabilization and corpectomy several days later. Histological examination of the tissue, including the paravertebral soft tissue, showed features of eosinophilic granuloma. After surgery, the patient returned to full activity. Eosinophilic granuloma of the spine is a rare disease in adults and may affect all the vertebral structures. Surgical treatment seems necessary for cases specifically involving progressive neurologic deficits.