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J Orthop Surg Res. 2018 Feb 2;13(1):26. doi: 10.1186/s13018-018-0715-3.

Analysis of C5 palsy in cervical myelopathy with massive anterior compression following laminoplasty.

Author information

1
Department of Orthopedics of First Affiliated Hospital and Orthopedic Institute of Soochow University, 188 Shizi St, Suzhou, Jiangsu Province, 215006, China.
2
Department of Orthopedics of First Affiliated Hospital and Orthopedic Institute of Soochow University, 188 Shizi St, Suzhou, Jiangsu Province, 215006, China. HuilinY@126.com.
3
Department of Orthopedics of First Affiliated Hospital and Orthopedic Institute of Soochow University, 188 Shizi St, Suzhou, Jiangsu Province, 215006, China. zongping_luo@yahoo.com.

Abstract

BACKGROUND:

Little data is available about comparison of the incidence and clinical characteristics of the C5 palsy between patients of cervical myelopathy with occupying ratio greater than 50% and those with occupying ratio less than 50% following laminoplasty.

METHODS:

One-hundred eighteen patients with cervical myelopathy who underwent open door laminoplasty were reviewed in this study. The patients were divided into two groups: group A comprising 55 patients with an anterior occupying ratio greater than 50% and group B comprising 63 patients with an anterior occupying less than 50%. Clinical and radiological outcomes were assessed between two groups.

RESULTS:

No statistically difference was found in preoperative Japanese Orthopedic Association (JOA) score of both groups (10.7 ± 1.7 in group A vs 10.9 ± 1.1 in group B, P > 0.05). Improvements in postoperative JOA score were achieved, and there was a statistical difference (14.0 ± 1.4 in group A vs 14.8 ± 0.9 in group B, P < 0.05). Group A had a lower rate of recovery than group B (P < 0.05). Totally, 12 of 118 (10.2%) patients developed the C5 palsy postoperatively. C5 palsy occurred in 3 of 63 patients in the group B compared with 9 of 55 in the group A. Statistically significant difference was found in the incidence of C5 palsy between the two groups (P < 0.05). Furthermore, patients in group A required significantly longer recovery periods than group B. Both preoperative and postoperative MRI presented more levels of T2 high-signal lesion in group A than group B. The degree of posterior shift of the cord after posterior decompression in group A was less than group B (P < 0.05).

CONCLUSIONS:

Patients with a high degree of anterior compression have higher risk of C5 palsy than those with a relative low degree of anterior compression.

KEYWORDS:

C5 palsy; Laminoplasty; Myelopathy; Result

PMID:
29394951
PMCID:
PMC5797409
DOI:
10.1186/s13018-018-0715-3
[Indexed for MEDLINE]
Free PMC Article

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