Risk Factor Analysis for C5 Palsy after Double-Door Laminoplasty for Cervical Spondylotic Myelopathy
| Autor: | Hideyuki Senba, Takahiro Kitamura, Ko Ikuta, Satoshi Shidahara, Satoshi Baba, Norihiro Komiya, Makoto Shiraki, Hiroko Ikeuchi |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
C5 palsy Nerve root medicine.medical_treatment lcsh:Medicine 03 medical and health sciences 0302 clinical medicine medicine Orthopedics and Sports Medicine 030212 general & internal medicine Risk factor Palsy business.industry Cervical spondylotic myelopathy lcsh:R Consecutive case series Odds ratio Spinal cord Laminoplasty Double door laminoplasty Confidence interval Surgery medicine.anatomical_structure Clinical Study business 030217 neurology & neurosurgery |
| Zdroj: | Asian Spine Journal Asian Spine Journal, Vol 10, Iss 2, Pp 298-308 (2016) |
| ISSN: | 1976-1902 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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