Risk Factors and Prevention of C5 Palsy After Anterior Cervical Decompression and Fusion: Similarity of the Pathomechanism With That After a Posterior Approach

Conclusions:

These results indicate that the pathomechanism of C5 palsy may be dependent on the location of the lateral decompression line, especially in patients with cervical kyphosis and a narrow C5 intervertebral foramen. Excessive lateral decompression beyond the Luchka joint might lead to C5 root kinking between the intervertebral foramen and posterior edge of vertebra. This pathomechanism may be similar in anterior and posterior approaches. To prevent C5 palsy, the medial line of the Luschka joint should be confirmed intraoperatively and decompression should be performed within the Luschka joints. Alternatively, medial foraminotomy should be used in cases needing wide decompression, such as those with massive ossification of the posterior longitudinal ligament, lateral osteophytes, and symptomatic foraminal stenosis.

Level of Evidence:

Level III.

Source: Journal of Spinal Disorders and Techniques - February 1, 2022 Category: Surgery Tags: Primary Research Source Type: research