C5 palsy after cervical Spine surgery

A multicenter retrospective review of 59 cases

Sara E. Thompson, Zachary A. Smith, Wellington K. Hsu, Ahmad Nassr, Thomas E. Mroz, David E. Fish, Jeffrey C. Wang, Michael G. Fehlings, Chadi A. Tannoury, Tony Tannoury, P. Justin Tortolani, Vincent C. Traynelis, Ziya Gokaslan, Alan S. Hilibrand, Robert E. Isaacs, Praveen V. Mummaneni, Dean Chou, Sheeraz A. Qureshi, Samuel K. Cho, Evan O. Baird & 26 others Rick C. Sasso, Paul M. Arnold, Zorica Buser, Mohamad Bydon, Michelle J. Clarke, Anthony F. De Giacomo, Adeeb Derakhshan, Bruce Jobse, Elizabeth L. Lord, Daniel Lubelski, Eric M. Massicotte, Michael P. Steinmetz, Gabriel A. Smith, Jonathan Pace, Mark Corriveau, Sungho Lee, Peter I. Cha, Dhananjay Chatterjee, Erica L. Gee, Erik N. Mayer, Owen J. McBride, Allison K. Roe, Marisa Y. Yanez, D. Alex Stroh, Khoi Than, K. Daniel Riew

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

Study Design: A multicenter, retrospective review of C5 palsy after cervical spine surgery. Objective: Postoperative C5 palsy is a known complication of cervical decompressive spinal surgery. The goal of this study was to review the incidence, patient characteristics, and outcome of C5 palsy in patients undergoing cervical spine surgery. Methods: We conducted a multicenter, retrospective review of 13 946 patients across 21 centers who received cervical spine surgery (levels C2 to C7) between January 1, 2005, and December 31, 2011, inclusive. P values were calculated using 2-sample t test for continuous variables and χ2 tests or Fisher exact tests for categorical variables. Results: Of the 13 946 cases reviewed, 59 patients experienced a postoperative C5 palsy. The incidence rate across the 21 sites ranged from 0% to 2.5%. At most recent follow-up, 32 patients reported complete resolution of symptoms (54.2%), 15 had symptoms resolve with residual effects (25.4%), 10 patients did not recover (17.0%), and 2 were lost to follow-up (3.4%). Conclusion: C5 palsy occurred in all surgical approaches and across a variety of diagnoses. The majority of patients had full recovery or recovery with residual effects. This study represents the largest series of North American patients reviewed to date.

Original languageEnglish (US)
Pages (from-to)64S-70S
JournalGlobal Spine Journal
Volume7
Issue number1_suppl
DOIs
StatePublished - Apr 1 2017

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Paralysis
Spine
Lost to Follow-Up
Incidence

Keywords

  • C5 palsy
  • cervical spine surgery
  • myelopathy
  • outcome
  • postoperative complication

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Thompson, S. E., Smith, Z. A., Hsu, W. K., Nassr, A., Mroz, T. E., Fish, D. E., ... Riew, K. D. (2017). C5 palsy after cervical Spine surgery: A multicenter retrospective review of 59 cases. Global Spine Journal, 7(1_suppl), 64S-70S. https://doi.org/10.1177/2192568216688189

C5 palsy after cervical Spine surgery : A multicenter retrospective review of 59 cases. / Thompson, Sara E.; Smith, Zachary A.; Hsu, Wellington K.; Nassr, Ahmad; Mroz, Thomas E.; Fish, David E.; Wang, Jeffrey C.; Fehlings, Michael G.; Tannoury, Chadi A.; Tannoury, Tony; Tortolani, P. Justin; Traynelis, Vincent C.; Gokaslan, Ziya; Hilibrand, Alan S.; Isaacs, Robert E.; Mummaneni, Praveen V.; Chou, Dean; Qureshi, Sheeraz A.; Cho, Samuel K.; Baird, Evan O.; Sasso, Rick C.; Arnold, Paul M.; Buser, Zorica; Bydon, Mohamad; Clarke, Michelle J.; De Giacomo, Anthony F.; Derakhshan, Adeeb; Jobse, Bruce; Lord, Elizabeth L.; Lubelski, Daniel; Massicotte, Eric M.; Steinmetz, Michael P.; Smith, Gabriel A.; Pace, Jonathan; Corriveau, Mark; Lee, Sungho; Cha, Peter I.; Chatterjee, Dhananjay; Gee, Erica L.; Mayer, Erik N.; McBride, Owen J.; Roe, Allison K.; Yanez, Marisa Y.; Stroh, D. Alex; Than, Khoi; Riew, K. Daniel.

In: Global Spine Journal, Vol. 7, No. 1_suppl, 01.04.2017, p. 64S-70S.

Research output: Contribution to journalReview article

Thompson, SE, Smith, ZA, Hsu, WK, Nassr, A, Mroz, TE, Fish, DE, Wang, JC, Fehlings, MG, Tannoury, CA, Tannoury, T, Tortolani, PJ, Traynelis, VC, Gokaslan, Z, Hilibrand, AS, Isaacs, RE, Mummaneni, PV, Chou, D, Qureshi, SA, Cho, SK, Baird, EO, Sasso, RC, Arnold, PM, Buser, Z, Bydon, M, Clarke, MJ, De Giacomo, AF, Derakhshan, A, Jobse, B, Lord, EL, Lubelski, D, Massicotte, EM, Steinmetz, MP, Smith, GA, Pace, J, Corriveau, M, Lee, S, Cha, PI, Chatterjee, D, Gee, EL, Mayer, EN, McBride, OJ, Roe, AK, Yanez, MY, Stroh, DA, Than, K & Riew, KD 2017, 'C5 palsy after cervical Spine surgery: A multicenter retrospective review of 59 cases', Global Spine Journal, vol. 7, no. 1_suppl, pp. 64S-70S. https://doi.org/10.1177/2192568216688189
Thompson SE, Smith ZA, Hsu WK, Nassr A, Mroz TE, Fish DE et al. C5 palsy after cervical Spine surgery: A multicenter retrospective review of 59 cases. Global Spine Journal. 2017 Apr 1;7(1_suppl):64S-70S. https://doi.org/10.1177/2192568216688189
Thompson, Sara E. ; Smith, Zachary A. ; Hsu, Wellington K. ; Nassr, Ahmad ; Mroz, Thomas E. ; Fish, David E. ; Wang, Jeffrey C. ; Fehlings, Michael G. ; Tannoury, Chadi A. ; Tannoury, Tony ; Tortolani, P. Justin ; Traynelis, Vincent C. ; Gokaslan, Ziya ; Hilibrand, Alan S. ; Isaacs, Robert E. ; Mummaneni, Praveen V. ; Chou, Dean ; Qureshi, Sheeraz A. ; Cho, Samuel K. ; Baird, Evan O. ; Sasso, Rick C. ; Arnold, Paul M. ; Buser, Zorica ; Bydon, Mohamad ; Clarke, Michelle J. ; De Giacomo, Anthony F. ; Derakhshan, Adeeb ; Jobse, Bruce ; Lord, Elizabeth L. ; Lubelski, Daniel ; Massicotte, Eric M. ; Steinmetz, Michael P. ; Smith, Gabriel A. ; Pace, Jonathan ; Corriveau, Mark ; Lee, Sungho ; Cha, Peter I. ; Chatterjee, Dhananjay ; Gee, Erica L. ; Mayer, Erik N. ; McBride, Owen J. ; Roe, Allison K. ; Yanez, Marisa Y. ; Stroh, D. Alex ; Than, Khoi ; Riew, K. Daniel. / C5 palsy after cervical Spine surgery : A multicenter retrospective review of 59 cases. In: Global Spine Journal. 2017 ; Vol. 7, No. 1_suppl. pp. 64S-70S.
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abstract = "Study Design: A multicenter, retrospective review of C5 palsy after cervical spine surgery. Objective: Postoperative C5 palsy is a known complication of cervical decompressive spinal surgery. The goal of this study was to review the incidence, patient characteristics, and outcome of C5 palsy in patients undergoing cervical spine surgery. Methods: We conducted a multicenter, retrospective review of 13 946 patients across 21 centers who received cervical spine surgery (levels C2 to C7) between January 1, 2005, and December 31, 2011, inclusive. P values were calculated using 2-sample t test for continuous variables and χ2 tests or Fisher exact tests for categorical variables. Results: Of the 13 946 cases reviewed, 59 patients experienced a postoperative C5 palsy. The incidence rate across the 21 sites ranged from 0{\%} to 2.5{\%}. At most recent follow-up, 32 patients reported complete resolution of symptoms (54.2{\%}), 15 had symptoms resolve with residual effects (25.4{\%}), 10 patients did not recover (17.0{\%}), and 2 were lost to follow-up (3.4{\%}). Conclusion: C5 palsy occurred in all surgical approaches and across a variety of diagnoses. The majority of patients had full recovery or recovery with residual effects. This study represents the largest series of North American patients reviewed to date.",
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AU - Smith, Zachary A.

AU - Hsu, Wellington K.

AU - Nassr, Ahmad

AU - Mroz, Thomas E.

AU - Fish, David E.

AU - Wang, Jeffrey C.

AU - Fehlings, Michael G.

AU - Tannoury, Chadi A.

AU - Tannoury, Tony

AU - Tortolani, P. Justin

AU - Traynelis, Vincent C.

AU - Gokaslan, Ziya

AU - Hilibrand, Alan S.

AU - Isaacs, Robert E.

AU - Mummaneni, Praveen V.

AU - Chou, Dean

AU - Qureshi, Sheeraz A.

AU - Cho, Samuel K.

AU - Baird, Evan O.

AU - Sasso, Rick C.

AU - Arnold, Paul M.

AU - Buser, Zorica

AU - Bydon, Mohamad

AU - Clarke, Michelle J.

AU - De Giacomo, Anthony F.

AU - Derakhshan, Adeeb

AU - Jobse, Bruce

AU - Lord, Elizabeth L.

AU - Lubelski, Daniel

AU - Massicotte, Eric M.

AU - Steinmetz, Michael P.

AU - Smith, Gabriel A.

AU - Pace, Jonathan

AU - Corriveau, Mark

AU - Lee, Sungho

AU - Cha, Peter I.

AU - Chatterjee, Dhananjay

AU - Gee, Erica L.

AU - Mayer, Erik N.

AU - McBride, Owen J.

AU - Roe, Allison K.

AU - Yanez, Marisa Y.

AU - Stroh, D. Alex

AU - Than, Khoi

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AB - Study Design: A multicenter, retrospective review of C5 palsy after cervical spine surgery. Objective: Postoperative C5 palsy is a known complication of cervical decompressive spinal surgery. The goal of this study was to review the incidence, patient characteristics, and outcome of C5 palsy in patients undergoing cervical spine surgery. Methods: We conducted a multicenter, retrospective review of 13 946 patients across 21 centers who received cervical spine surgery (levels C2 to C7) between January 1, 2005, and December 31, 2011, inclusive. P values were calculated using 2-sample t test for continuous variables and χ2 tests or Fisher exact tests for categorical variables. Results: Of the 13 946 cases reviewed, 59 patients experienced a postoperative C5 palsy. The incidence rate across the 21 sites ranged from 0% to 2.5%. At most recent follow-up, 32 patients reported complete resolution of symptoms (54.2%), 15 had symptoms resolve with residual effects (25.4%), 10 patients did not recover (17.0%), and 2 were lost to follow-up (3.4%). Conclusion: C5 palsy occurred in all surgical approaches and across a variety of diagnoses. The majority of patients had full recovery or recovery with residual effects. This study represents the largest series of North American patients reviewed to date.

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KW - cervical spine surgery

KW - myelopathy

KW - outcome

KW - postoperative complication

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