Preoperatively, Which Parameter Allows Us to Predict the C5 Palsy After Cervical Open-Door Laminoplasty?

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Uzunoglu I., Gurkan G., Cingoz I. D., Atar M., Kaya I., COŞKUN E., ...More

Turkish Neurosurgery, vol.33, no.1, pp.110-117, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 33 Issue: 1
  • Publication Date: 2023
  • Doi Number: 10.5137/1019-5149.jtn.38560-22.2
  • Journal Name: Turkish Neurosurgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.110-117
  • Keywords: Open-door cervical laminoplasty, OPLL, C5 palsy, Cervical spondylotic myelopathy, C4, 5 foramina diameter
  • Kütahya Health Sciences University Affiliated: Yes

Abstract

© 2023,Turkish Neurosurgery.All Rights Reserved.AIM: To uncover factors that can predict the development of C5 palsy before surgery by evaluating several different parameters. MATERIAL and METHODS: A total of 177 patients who underwent surgery between 2015 and 2020 were included in the study. In total, C5 palsy was observed in 22 (12.4%) of our patients. The radiological and clinical data of the patients were retrospectively analyzed and added to the data. RESULTS: A total of 177 patients who satisfied the criteria were included in the study, among whom 117 (66.1%) and 60 (33.9%) were male and female, respectively. Patients with ossified posterior longitudinal ligament (OPLL) (92; 52.0%) needed surgery the most. C5 palsy developed in 16/92 (17.3%) patients who had surgery for OPLL. This result was statistically significant (p<0.001). However, a significant difference in the postoperative Pavlov ratio was noted between both groups (p=0.027). The foraminal dimensions for the C5 palsy group were significantly lower than those for the non-C5 palsy group. CONCLUSION: Smaller C5 root foramina diameter measurements were the most important predictive factor for the development of C5 palsy after open-door cervical laminoplasty. Although the pathophysiology remains to be fully understood, ischemia-reperfusion injury supposedly plays a role therein.