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
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.
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