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KMID : 1189320160100020298
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Asian Spine Journal
2016 Volume.10 No. 2 p.298 ~ p.308
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Risk Factor Analysis for C5 Palsy after Double-Door Laminoplasty for Cervical Spondylotic Myelopathy
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Baba Satoshi
Ikuta Ko
Ikeuchi Hiroko
Shiraki Makoto
Komiya Norihiro
Kitamura Takahiro
Senba Hideyuki
Shidahara Satoshi
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Abstract
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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.
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KEYWORD
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C5 palsy, Double door laminoplasty, Cervical spondylotic myelopathy
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