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the incidence of c5 palsy after multilevel cervical decompression procedures: a review of 750 consecutive cases.

Introduction. C5 Palsy rates vary in the literature ranging from 0-30%.1-3 Symptoms may include:paresis of the deltoid and/or biceps brachii musclesensory deficits and/or intractable pain in the shoulders. The etiology remains uncertainiatrogenic nerve injury during surgery4 tethering of the nerve from shifting of the spinal cord5spinal cord ischemia6reperfusion injury of the spinal cord.7The rate of C5 nerve palsy with different surgical procedures is unclear..

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the incidence of c5 palsy after multilevel cervical decompression procedures: a review of 750 consecutive cases.

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    1. The Incidence of C5 Palsy after Multilevel Cervical Decompression Procedures: A Review of 750 Consecutive Cases. Ahmad Nassr, MD Jason C. Eck, DO, MS Ravi K. Ponnappan, MD Rami R. Zanoun, BS William F. Donaldson, III, MD James D. Kang, MD

    2. Introduction C5 Palsy rates vary in the literature ranging from 0-30%.1-3 Symptoms may include: paresis of the deltoid and/or biceps brachii muscle sensory deficits and/or intractable pain in the shoulders. The etiology remains uncertain iatrogenic nerve injury during surgery4 tethering of the nerve from shifting of the spinal cord5 spinal cord ischemia6 reperfusion injury of the spinal cord.7 The rate of C5 nerve palsy with different surgical procedures is unclear.

    3. Purpose The purpose of this study was to review the incidence of postoperative C5 nerve palsy in a large consecutive series of multilevel cervical spine decompression procedures to determine if any patient factors or surgical approach affected the incidence.

    4. Methods Retrospective review of 750 consecutive patients after multilevel cervical decompression. Patients divided into 4 categories: Anterior Corpectomy Anterior Decomp/Posterior Fusion Laminectomy and Fusion Laminaplasty Patients were excluded if: there was lack of adequate follow-up data spinal cord injury preventing preoperative or postoperative motor testing or if the decompressive surgery did not include the C5 level.

    5. Results 120 patients excluded 630 Patients Included 292 Females, 338 Males Ages 19-87 (mean 58 yo) 255 Corpectomy Pts 154 Anterior/Poster Fusion Pts 116 Laminectomy and Fusion Pts 105 Laminaplasty Pts C5 Palsy rate = 6.7% (42/630pts)

    6. Summary of Demographics and Results

    7. Entire Group Compared

    8. Anterior/Posterior Fusion

    9. Corpectomy Group

    10. Laminectomy/Fusion Group

    11. Laminaplasty Group

    12. Summary Largest group of North American patients evaluated to determine the incidence of C5 Palsy 6.7% Rate of C5 Palsy is consistent with previous published reports Rate varies with surgical procedure chosen but did not reach statistical significance

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