Journals / Journal of Turkish Spinal Surgery / 2008 / Cilt: 19 - Sayı: 4

Iatroganic C-5 palsy and it’s treatment: A rare complication after cervical decompresion surgery

İyatrojenik C5 palsi ve tedavisi: Servikal dekompresyon cerrahisi sonrasında görülen nadir bir komplikasyon

Pages
453–460
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In our case, a regular rehabilitation program provided a total cure and our patient recovered without any need for further follow-up.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:A cervical decompression surgery with laminectomy of C3-6 was performed on an 80- year old female patient for cervical spinal stenosis and myelomalacia.
📊
Key Findings & Data:The patient had an acute paresis on the left shoulder on the 3rd postoperative day and her electrophysiological examination revealed a C5 palsy.
💡
Conclusion & Impact:In our case, a regular rehabilitation program provided a total cure and our patient recovered without any need for further follow-up.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Yaşlı · Kadın · Laminektomi

Abstract

A cervical decompression surgery with laminectomy of C3-6 was performed on an 80- year old female patient for cervical spinal stenosis and myelomalacia. The patient had an acute paresis on the left shoulder on the 3rd postoperative day and her electrophysiological examination revealed a C5 palsy. The patient, who underwent an exercise and rehabilitation program, recovered at the end of the first postoperative year. Surgeons performing spinal decompression surgery need to be aware of complications involving C5 palsy, which has a high morbidity and no specific treatment. Recognizing C5 palsy during a differential diagnosis of other causes of paresis can prevent unnecessary revision surgery attempts. In our case, a regular rehabilitation program provided a total cure and our patient recovered without any need for further follow-up.

Özet

Servikal 3-6 spinal stenoz ve miyelomalazi teşhisi ile servikal laminektomi uygulanan 80 yaşında bayan hastanın ameliyat sonrası 3. günde sol omzunda akut bir parezi gelişti. Sol deltoid ve biseps kas güçleri, 1/5 olarak saptanan hastanın yapılan elektrofizyolojik incelemesi sonucunda iyatrojenik C5 palsi tanısı kondu ve hasta rehabilitasyon programına alındı. Yaklaşık 10 ay süreyle egzersiz ve rehabilitasyon programına devam edilen hasta 1. yılın sonunda tam olarak iyileşti. Servikal dekompresyon cerrahisi ile ilgilenen hekimler morbiditesi yüksek olan ve spesifik bir tedavisi bulunmayan C5 palsi komplikasyonu konusunda bilgili olmalı ve gerektiğinde hastalarını bu konuda aydınlatmalıdır. C5 palsinin diğer parezi nedenlerinin ayırıcı tanısında akla getirilmesi gereksiz revizyon girişimlerinin yapılmasını önleyebilir. Olgumuzda ağır bir C5 palsi komplikasyonu sonrasında uygulanan düzenli rehabilitasyon programı tam düzelme sağlamış ve hastamız sekelsiz iyileşmiştir.

🔖

Cite This Article

SİYAHİ, A., COŞKUNSU, D. K., ŞAR, C. (2008). Iatroganic C-5 palsy and it’s treatment: A rare complication after cervical decompresion surgery. Journal of Turkish Spinal Surgery, Cilt: 19 - Sayı: 4, 453–460. https://ajindex.com/articles/271521

References (9)

  1. Bose B, Sestokas AK, Schwartz DM. Neurophysiological detection of iatrogenic C-5 nerve deficit during anterior cervical spinal surgery. J Neurosurg Spine 2007; 6 (5): 381-385
  2. Chiba K, Toyama Y, Matsumoto M, Maruiwa H, Watanabe M, Hirabayashi K. Segmental motor paralysis after expansive open-door laminoplasty. Spine 2002; 27: 2108-2115
  3. Edwards CC, Heller JG, Silcox III DH. T-saw laminoplasty for the management of cervical spondylotic myelopathy; Clinical and radiographic outcome. Spine 2000; 25: 1788-1794
  4. Epstein N. Anterior approaches to cervical spondylosis and ossification of the posterior longitudinal ligament: Review of operative technique and assessment of 65 multilevel circumferential procedures. Surg Neurol 2001; 55:313-324
  5. Fan D, Schwartz DM, Vaccaro AR, Hilibrand AS, Albert TJ. Intraoperative neurophysiologic detection of iatrogenic C5 nerve root injury during laminectomy for cervical compression myelopathy. Spine 2002; 27: 2499-2502
  6. Hirabayashi K, Toyama Y, Chiba K. Expansive laminoplasty for myelopathy in ossification of the posterior longitudinal ligament. Clin Orthop 1999; 359: 35-48
  7. Komagata M, Nishiyama M, Endo K, Ikegami H, Tanaka S, Imakiire A. Prophylaxis of C5 palsy after cervical expansive laminoplasty by bilateral partial foraminotomy. Spine J 2004; 4 (6): 650-655
  8. Liyang Dai, Bin Ni, Wen Yuan, Lianshun Jia. Radiculopathy after laminectomy for cervical compression myelopathy. J Bone Joint Surg [Br] 1998; 80-B: 846-849
  9. Rovira M, Torrent O, Ruscaleda J. Some aspects of the spinal cord circulation in cervical myelopathy. Neuroradiology 1975; 9: 209-214. 10.Sakaura H, Hosono N, Mukai Y, Ishii T, Yoshikawa H. C5 palsy after decompression surgery for cervical myelopathy: review of the literature. Spine 2003; 28: 2447-2451. 11.Sasai K, Saito T, Akagi S, Kato I, Ohnari H, Iida H. Preventing C5 palsy after laminoplasty. Spine 2003; 28 (17):1972-1977. 12.Satomi K, Nishu Y, Kohno T, Hirabayashi K. Long-term follow-up studies of open-door expansive laminoplasty for cervical stenotic myelopathy. Spine 1994; 19: 507-510. 13.Scoville WB. Cervical spondylosis treated by bilateral facetectomy and laminectomy. J Neurosurg 1961; 18: 423-428. 14.Sodeyama T, Goto S, Mochizuki M, Takahashi J, Moriya H. Effect of decompression enlargement laminoplasty for posterior shifting of the spinal cord. Spine 1999; 24: 1527-1531. 15.Stoops WL. Neural complication of cervical spondylosis; their response to laminectomy and foraminotomy.