ABSTRACT
Objective To evaluate the clinical and radiological factors which affecting the recovery duration of C5 palsy after cervical decompression surgery.Methods The datas of 710 patients with degenerative cervical spine surgery in departement of spine surgery of orthopaedics of general hospital of Shenyang military region were retrospectively analyzed.The demographics,radiology,clinical information were recorded to analyze the relationship with the recovery duration of postoperative C5 palsy.Results C5 nerve root palsy occurred in 36 cases,of which 33 cases completely recovered within 2 years after surgery(18 cases recovered within postoperative 6 months),3 cases did not completely recovered during the following period.Factors related to longer recovery(over 6 months) included postoperative limbs muscles strength ≤2(P＜0.01),presence of multi-segment paresis involving more than the C5 root(P =0.002),loss of somatic sensation with pain(P =0.008),and the degree of posterior spinal cord shifting (P =0.040).Furthermore,multivariate analysis revealed that postoperative limbs muscles strength ≤2(P =0.010) had a significant effect on a recovery duration beyond 6 months.Conclusion The postoperative limbs muscles strength ≤2,the presence of multi-segment paresis involving more than the C5 root,the loss of somatic sensation with pain,and the degree of posterior spinal cord shifting are main factors which significantly influence the duration of recovery from postoperative C5 nerve root palsy.
ABSTRACT
BACKGROUND:Some scholars suggest that the nerve root palsy after cervical spinal stenosis treated with decompression and implant internal fixation is related with the cervical stability and cervical lordosis, but there is controversial. OBJECTIVE:To explore the C 5 nerve root palsy and stability after cervical spinal stenosis treated with posterior laminectomy lateral mass fixation and single-door decompression laminoplasty. METHODS:Twenty-nine cervical spinal stenosis patients were selected and treated with posterior decompression and implant internal fixation. Posterior laminectomy lateral mass fixation for the treatment of cervical spinal stenosis:C3-6 lateral mass and C7 pedicel screw internal fixation was performed and caused rough surface on the facet joint;the unstable segment was confirmed according to the preoperative anteraposterior plain film and dynamic radiographs combined with MRI and CT images, and then the corresponding segments were treated with lateral mass internal fixation, single-door decompression laminoplasty and laminoplasty. RESULTS AND CONCLUSION:Al the 29 cervical spinal stenosis patients were fol owed-up for 8 months to 2.3 years. Among them, 14 cases were treated with posterior laminectomy lateral mass fixation, two cases had nerve root palsy in the early stage after implantation, three cases had incomplete paralysis after long-term symptom recurrence and treated with second surgery of scar remove and decompression;15 cases were treated with single-door decompression laminoplasty, and one case had C 5 never root palsy and shoulder abduction dysfunctionafter treatment, no preoperative symptom recurrence. The nerve root palsy wil restored in 6 weeks for shortest and 9 months for longest. As the limitation of the case number, it is not clear whether there were significant differences in the correlation between C 5 nerve root palsy and segmental stability, cervical lordosis, spinal decompression degree and the range for spinal cord shift, as wel as the nerve root palsy degree and the cervical spinal stenosis recurrence caused by forward scar between two treatment methods, so accumulation observation of the cases and clinical experience are needed.