Risk Factor Analysis for C5 Palsy after Double-Door Laminoplasty for Cervical Spondylotic Myelopathy.
10.4184/asj.2016.10.2.298
- Author:
Satoshi BABA
1
;
Ko IKUTA
;
Hiroko IKEUCHI
;
Makoto SHIRAKI
;
Norihiro KOMIYA
;
Takahiro KITAMURA
;
Hideyuki SENBA
;
Satoshi SHIDAHARA
Author Information
1. Department of Orthopaedic Surgery, Karatsu Red Cross Hospital, Karatsu, Japan. Satoshi7147@gmail.com
- Publication Type:Comparative Study ; Original Article
- Keywords:
C5 palsy;
Double door laminoplasty;
Cervical spondylotic myelopathy
- MeSH:
Humans;
Logistic Models;
Paralysis*;
Pathology;
Retrospective Studies;
Risk Factors*;
Spinal Cord;
Spinal Cord Diseases*
- From:Asian Spine Journal
2016;10(2):298-308
- CountryRepublic of Korea
- Language:English
-
Abstract:
STUDY DESIGN: A retrospective comparative study. PURPOSE: To clarify the risk factors related to the development of postoperative C5 palsy through radiological studies after cervical double-door laminoplasty (DDL). OVERVIEW OF LITERATURE: Although postoperative C5 palsy is generally considered to be the result of damage to the nerve root or segmental spinal cord, the associated pathology remains controversial. METHODS: A consecutive case series of 47 patients with cervical spondylotic myelopathy treated by DDL at our institution between April 2008 and April 2015 were reviewed. Postoperative C5 palsy occurred in 5 of 47 cases after DDL. We investigated 9 radiologic factors that have been reported to be risk factors for C5 palsy in various studies, and statistically examined these between the two groups of palsy and the non-palsy patients. RESULTS: We found a significant difference between patients with and without postoperative C5 palsy with regards to the posterior shift of spinal cord at C4/5 (p=0.008). The logistic regression analyses revealed posterior shift of the spinal cord at C4/5 (odds ratio, 12.066; p=0.029; 95% confidence interval, 1.295–112.378). For the other radiologic factors, there were no statistically significant differences between the two groups. CONCLUSIONS: In the present study, we showed a significant difference in the posterior shift of the spinal cord at C4/5 between the palsy and the non-palsy groups, indicating that the "tethering phenomenon" was likely a greater risk factor for postoperative C5 palsy.
