scholarly journals Could Machine Learning Better Predict Postoperative C5 Palsy of Cervical Ossification of the Posterior Longitudinal Ligament?

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Soo Heon Kim ◽  
Sun Ho Lee ◽  
Dong Ah Shin
Keyword(s):  
Machine Learning ◽  
Posterior Longitudinal Ligament ◽  
C5 Palsy

scholarly journals Does Diabetes Affect the Surgical Outcomes in Cases With Cervical Ossification of the Posterior Longitudinal Ligament? A Multicenter Study From Asia Pacific Spine Study Group

2021 ◽  
pp. 219256822199630
Author(s):  
Narihito Nagoshi ◽  
Kota Watanabe ◽  
Masaya Nakamura ◽  
Morio Matsumoto ◽  
Nan Li ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Surgical Outcomes ◽  
Hemoglobin A1c ◽  
Perioperative Complications ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Asia Pacific ◽  
C5 Palsy ◽  
Significant Difference ◽  
The Impact

Study Design: Retrospective multicenter study. Objectives: To evaluate the surgical outcomes of cervical ossification of the posterior longitudinal ligament (OPLL) in diabetes mellitus (DM) patients. Methods: Approximately 253 cervical OPLL patients who underwent surgical decompression with or without fixation were registered at 4 institutions in 3 Asian countries. They were followed up for at least 2 years. Demographics, imaging, and surgical information were collected, and cervical Japanese Orthopaedic Association (JOA) scores and the visual analog scale (VAS) for the neck were used for evaluation. Results: Forty-seven patients had DM, showing higher hypertension and cardiovascular disease prevalence. Although they presented worse preoperative JOA scores than non-DM patients (10.5 ± 3.1 vs. 11.8 ± 3.2; P = 0.01), the former showed comparable neurologic recovery at the final follow-up (13.9 ± 2.9 vs. 14.2 ± 2.6; P = 0.41). No correlation was noted between the hemoglobin A1c level in the DM group and the pre- and postoperative JOA scores. No significant difference was noted in VAS scores between the groups at pre- and postsurgery. Regarding perioperative complications, DM patients presented a higher C5 palsy frequency (14.9% vs. 5.8%; P = 0.04). A similar trend was observed when surgical procedure was limited to laminoplasty. Conclusions: This is the first multicenter Asian study to evaluate the impact of DM on cervical OPLL patients. Surgical results were favorable even in DM cases, regardless of preoperative hemoglobin A1c levels or operative procedures. However, caution is warranted for the occurrence of C5 palsy after surgery.

scholarly journals A Case of Successful Foraminotomy for Severe Bilateral C5 Palsy following Posterior Decompression and Fusion Surgery for Cervical Ossification of Posterior Longitudinal Ligament

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Yoshifumi Kudo ◽  
Tomoaki Toyone ◽  
Toshiyuki Shirahata ◽  
Tomoyuki Ozawa ◽  
Akira Matsuoka ◽  
...  
Keyword(s):  
Standard Procedure ◽  
Posterior Longitudinal Ligament ◽  
Muscular Contraction ◽  
Foraminal Stenosis ◽  
Posterior Decompression ◽  
Fusion Surgery ◽  
C5 Palsy ◽  
Postoperative Mri ◽  
Cervical Surgery ◽  
Complete Paralysis

We report a very rare (5~7%) case of bilateral C5 palsy after cervical surgery. A 71-year-old male patient with cervical ossification of posterior longitudinal ligament (OPLL) with foraminal stenosis at bilateral C4/5 underwent posterior decompression and fusion surgery. After surgery, muscle weakness in his both deltoid and biceps was detected and gradually deteriorated to complete paralysis. Postoperative MRI showed sufficient decompression of the spinal cord and posterior shifting. Subsequently, an additional bilateral foraminotomy at C4/5 was performed, with a suspicion that bilateral foraminal stenosis at C4/5 may have been the cause of the paresis. After foraminotomy, muscular contraction was seen in both deltoid and biceps. Finally, complete motor recovery was achieved in a year. Although the gold standard procedure for the prevention and treatment of postoperative C5 palsy has not yet been established, an additional foraminotomy may be recommended for severe C5 palsy in cases of foraminal stenosis even after the occurrence of palsy.

scholarly journals C5 palsy in the treatment of cervical spondylosis myelopathy with ossification of the posterior longitudinal ligament

2020 ◽  
Author(s):  
denglu yan ◽  
Zaiheng Zhang ◽  
Zhi Zhang
Keyword(s):  
Spinal Cord ◽  
Clinical Outcomes ◽  
Cervical Spondylosis ◽  
Posterior Longitudinal Ligament ◽  
Posterior Surgery ◽  
C5 Palsy ◽  
Dural Sac ◽  
Csf Leakage ◽  
The Mean ◽  
Cervical Spondylosis Myelopathy

Abstract Background There are many factors that affect the C5 palsy in the treatment of cervical spondylosis myelopathy (CSM) with ossification of the posterior longitudinal ligament (OPLL), but the spinal compression degrees may be an important factor in affection on it. Objective The purpose of this study was to evaluate the effect of spinal cord compression degrees on the clinical outcomes of OPLL patients which been treated by anterior and posterior surgery. Methods From May 2010 to October 2017, 145 patients cervical spondylosis myelopathy with OPLL (spinal canal narrowing by the OPLL exceeded 30%) were enrolled in this study; 76 patients received anterior cervical corpectomy and fusion surgery (ACCF), and 69 patients had posterior cervical decompression and laminoplasty procedures (PCDL). The clinical outcomes of pain relief (visual analog scale, VAS), functional disability (neck disability index, NDI) were recorded at baseline and at the final follow-up. Results There were five patients with C5 palsy in this series cases (two in ACCF and three in PCDL), and the rate is 4.1% (3.2% in ACCF and 5.2% in PCDL, P > 0.05). Five C5 palsy cases had more than 50% compressed degrees of dural sac and flattened spinal cord, and the compressed dural sac and flattened spinal cord had totally expansion after operation. There were no patients resented with CSF leakage in PCDL group, and six patients presented with CSF leakage in ACCF. The mean postoperative canal diameter were significant better than preoperative in PDL patients (P < 0.01). The average spinal sagittal and axial compressive ratio were significantly decreased from preoperative in ACR and PDL groups (P < 0.01). The mean cervical ROM values were decreased in ACR and PDL groups (P< 0.05). Conclusions Based on the results of this study, anterior and posterior surgery was effective and safe in the treatment of the OPLL patients. The complication of C5 palsy were no related in the surgery methods, but may be related the degrees of spinal cord compressed.

Does Resection of the Posterior Longitudinal Ligament Impact the Incidence of C5 Palsy After Cervical Corpectomy Procedures?

Spine ◽  
2017 ◽  
Vol 42 (7) ◽  
pp. E392-E397 ◽  
Author(s):  
Ahmad Nassr ◽  
Ilyas S. Aleem ◽  
Jason C. Eck ◽  
Barrett Woods ◽  
Ravi K. Ponnappan ◽  
...  
Keyword(s):  
Posterior Longitudinal Ligament ◽  
Cervical Corpectomy ◽  
C5 Palsy

Does Resection of the Posterior Longitudinal Ligament Impact the Incidence of C5 Palsy After Cervical Corpectomy Procedures? A Review of 459 Consecutive Cases

2011 ◽  
Vol 11 (10) ◽  
pp. S12
Author(s):  
Ahmad Nassr ◽  
Jason Eck ◽  
Barrett Woods ◽  
Ravi Ponnappan ◽  
William Donaldson ◽  
...  
Keyword(s):  
Posterior Longitudinal Ligament ◽  
Cervical Corpectomy ◽  
C5 Palsy

scholarly journals C5 nerve root palsy after posterior cervical spine surgery

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668450 ◽  
Author(s):  
Fu-Min Pan ◽  
Shan-Jin Wang ◽  
Bin Ma ◽  
De-Sheng Wu
Keyword(s):  
Risk Factors ◽  
Preventive Measures ◽  
Biceps Brachii ◽  
Early Stage ◽  
Posterior Longitudinal Ligament ◽  
Intraoperative Neuromonitoring ◽  
Decompression Surgery ◽  
Lower Extremity Function ◽  
Cervical Spine Surgery ◽  
C5 Palsy

Background: C5 palsy is a serious complication after cervical decompression surgery in which the patient shows a deterioration in power of the deltoid or biceps brachii by at least one grade in the manual muscle test without aggravation of lower extremity function. Although there are several hypotheses regarding the etiology of C5 palsy, the pathogenesis and preventive measures remain unidentified and many other controversies remain. Objective: To systematically review the clinical features, risk factors, mechanism, and preventive measures of C5 palsy after posterior cervical decompression surgery. Materials and methods: PubMed was searched to identify eligible studies that contained more than 10 cases and focused on C5 palsy. Microsoft Excel was used to analyze the data. Statistical comparisons were made when appropriate. Results: Out of 718 papers involving C5 palsy, 28 met the inclusion criteria. The average incidence rate was 7.8% (range, 1.4–23.0%). Risk factors for C5 palsy included age, male gender, ossification of the posterior longitudinal ligament, and stenosis of the C4–C5 intervertebral foramen. C5 palsy occurred from immediately to 2 months after surgery, and recovery time ranged from 48 h to 41 months. Hypotheses for the mechanism of C5 palsy included root involvement and spinal cord impairment. Foraminotomy and intraoperative neuromonitoring were the two main methods used to prevent C5 palsy. Conclusion: C5 palsy is a serious complication occurring at the early stage after cervical decompression surgery. Foraminotomy and intraoperative neuromonitoring were the two main methods to prevent C5 palsy. The incidence of C5 palsy is low, but it can place a serious burden on the patients’ quality of life and finances. The risk factors and mechanism of C5 palsy are still controversial. However, under conservative therapy, the prognosis is usually good. Higher quality studies are necessary for drawing more reliable and convincing conclusions about this disease.

C5 Palsy After Laminectomy and Posterior Cervical Fixation for Ossification of Posterior Longitudinal Ligament

2007 ◽  
Vol 20 (7) ◽  
pp. 533-535 ◽  
Author(s):  
Yu Chen ◽  
Deyu Chen ◽  
Xinwei Wang ◽  
Yongfei Guo ◽  
Zhimin He
Keyword(s):  
Posterior Longitudinal Ligament ◽  
C5 Palsy

Laminoplasty versus laminectomy with fusion for treatment of multilevel cervical compressive myelopathy: an updated meta-analysis

2021 ◽  
pp. postgradmedj-2020-139667
Author(s):  
Jing Wang ◽  
Jin Wo ◽  
Jun Wen ◽  
Liu Zhang ◽  
Weiwei Xu ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Japanese Orthopaedic Association ◽  
Neck Disability Index ◽  
Vertical Axis ◽  
Posterior Longitudinal Ligament ◽  
Cochrane Library ◽  
Sagittal Vertical Axis ◽  
C5 Palsy ◽  
Cervical Compressive Myelopathy ◽  
Neck Disability

BackgroundMultilevel cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) are debilitating degenerative diseases. If conservative treatment is ineffective, surgical options for multilevel CSM and OPLL include laminoplasty (LP) and laminectomy with fusion (LF). In this updated meta-analysis, we aimed to compare the clinical outcomes and complications of both approaches.MethodsWe searched PubMed, the Cochrane Library and Embase datasets from their inception to 31 March 2020, to identify all eligible studies comparing LP versus LF for multilevel CSM and OPLL. Data were extracted according to predefined endpoints. We summarised data by the random-effects or fixed-effect models, as necessary.ResultsOf 533 eligible studies, 16 were identified, which included 638 patients who underwent LP and 671 patients who underwent LF. No significant differences were observed between preoperative and postoperative scores of the Japanese Orthopaedic Association (p=1.0 and 0.20, respectively); Visual Analogue Scale (p=0.24 and 0.89, respectively); sagittal vertical axis ((p=0.16 and 0.87, respectively); Nurick Scale (p=0.59 and 0.17, respectively); and range of motion (p=0.67 and 0.63, respectively). However, total complications were higher for LF compared with LP (p=0.006). A significantly higher incidence of C5 palsy was observed in the LF group (p=0.004). The postoperative Neck Disability Index (NDI) was also higher in the LF group (p<0.001).ConclusionsAlthough LP and LF shared similar clinical improvement, LP had fewer complications, a lower incidence of C5 palsy, and better NDI scores and recovery outcomes than LF. Randomised studies are warranted to validate these findings.

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