Critical points and effectiveness of prophylactic C4/5 foraminotomy to prevent C5 palsy after posterior cervical spine surgery

C5 palsy is a serious complication that may occur after cervical spine surgery; however, standard procedures for shoulder rehabilitation for patients with postoperative C5 palsy have not yet been established. We used a wearable robot suit Hybrid Assistive Limb (HAL) in a patient with delayed recovery after postoperative C5 palsy and conducted shoulder abduction training with the HAL. A 62-year-old man presented with weakness in his left deltoid muscle 2 days after cervical spine surgery. He experienced great difficulty in elevating his left arm and was diagnosed with postoperative C5 palsy. Seven months after surgery, shoulder abduction training with a HAL was initiated. In total, 23 sessions of shoulder HAL rehabilitation were conducted until 26 months after surgery. His shoulder abduction angle and power improved at every HAL session, and he was able to fully elevate his arm without any compensatory movement after the 23rd session, suggesting that the HAL is a useful tool for shoulder rehabilitation in patients with postoperative C5 palsy. We employed shoulder HAL training for a patient with delayed recovery from postoperative C5 palsy and achieved complete restoration of shoulder function. We believe that the HAL-based training corrected the erroneous motion pattern of his paralyzed shoulder and promoted errorless motor learning for recovery. Our collective experience suggests that shoulder HAL training could be an effective therapeutic tool for patients with postoperative C5 palsy.

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Application of Smith-Robinson approach for C2/3 cervical spine surgery

Academic Journal of Second Military Medical University ◽

10.3724/sp.j.1008.2012.01199 ◽

2013 ◽

Vol 32 (11) ◽

pp. 1199-1202

Author(s):

Ying ZHANG ◽

Jun MA ◽

Yuan-yuan CHEN ◽

Xin-wei WANG ◽

De-yu CHEN ◽

...

Keyword(s):

Cervical Spine ◽

Spine Surgery ◽

Cervical Spine Surgery

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Impact of Diabetes Mellitus on Cervical Spine Surgery for Ossification of the Posterior Longitudinal Ligament

Journal of Clinical Medicine ◽

10.3390/jcm10153375 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3375

Author(s):

Atsushi Kimura ◽

Katsushi Takeshita ◽

Toshitaka Yoshii ◽

Satoru Egawa ◽

Takashi Hirai ◽

...

Keyword(s):

Diabetes Mellitus ◽

Cervical Spine ◽

Postoperative Complications ◽

Spine Surgery ◽

Posterior Longitudinal Ligament ◽

Lower Extremity Function ◽

Cervical Spine Surgery ◽

The Impact

Ossification of the posterior longitudinal ligament (OPLL) is commonly associated with diabetes mellitus (DM); however, the impact of DM on cervical spine surgery for OPLL remains unclear. This study was performed to evaluate the influence of diabetes DM on the outcomes following cervical spine surgery for OPLL. In total, 478 patients with cervical OPLL who underwent surgical treatment were prospectively recruited from April 2015 to July 2017. Functional measurements were conducted at baseline and at 6 months, 1 year, and 2 years after surgery using JOA and JOACMEQ scores. The incidence of postoperative complications was categorized into early (≤30 days) and late (>30 days), depending on the time from surgery. From the initial group of 478 patients, 402 completed the 2-year follow-up and were included in the analysis. Of the 402 patients, 127 (32%) had DM as a comorbid disease. The overall incidence of postoperative complications was significantly higher in patients with DM than in patients without DM in both the early and late postoperative periods. The patients with DM had a significantly lower JOA score and JOACMEQ scores in the domains of lower extremity function and quality of life than those without DM at the 2-year follow-up.

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