Bilateral C5 Motor Palsy after Anterior Cervical Decompression and Fusion: A Case Report and Review of the Literature

Background Bilateral C5 motor palsy is a rare but potentially debilitating complication after cervical spine decompression with very few reports in the published literature. Purpose To present a case of bilateral C5 motor palsy after anterior cervical decompression and fusion and discuss the incidence and risk factors of this complication. Study Design/Setting We report a case of a 57-year-old male who underwent a three level C3-C6 anterior cervical discectomy and fusion with instrumentation who developed a postoperative bilateral C5 motor palsy. Methods A review of the literature was performed regarding reports on and incidence of post-operative bilateral C5 palsy following either anterior or posterior cervical spine decompression. Results Bilateral C5 motor palsy is a rare complication of cervical spine decompression with an overall incidence of 0.38%. Although a group of risk factors have been suggested no single cause has been identified. Conclusions Bilateral C5 motor palsy is a rare but debilitating complication of cervical decompression.

[1]  T. Witham,et al.  Development of postoperative C5 palsy is associated with wider posterior decompressions: an analysis of 41 patients. , 2014, The spine journal : official journal of the North American Spine Society.

[2]  E. Benzel,et al.  C5 palsy after posterior cervical decompression and fusion: cost and quality-of-life implications. , 2014, The spine journal : official journal of the North American Spine Society.

[3]  A. Nowacki,et al.  Predicting C5 palsy via the use of preoperative anatomic measurements. , 2014, The spine journal : official journal of the North American Spine Society.

[4]  A. Hecht,et al.  C5 nerve root palsy following decompression of the cervical spine: a systematic evaluation of the literature. , 2014, The bone & joint journal.

[5]  A. Marquez-Lara,et al.  Complications of Spinal Fusion With Utilization of Bone Morphogenetic Protein: A Systematic Review of the Literature , 2014, Spine.

[6]  S. Balsis,et al.  The association between preoperative spinal cord rotation and postoperative C5 nerve palsy. , 2012, The Journal of bone and joint surgery. American volume.

[7]  N. Hamajima,et al.  Multivariate analysis of C-5 palsy incidence after cervical posterior fusion with instrumentation. , 2012, Journal of neurosurgery. Spine.

[8]  James D. Kang,et al.  The Incidence of C5 Palsy After Multilevel Cervical Decompression Procedures: A Review of 750 Consecutive Cases , 2012, Spine.

[9]  Kazuhisa Takahashi,et al.  C5 palsy following anterior decompression and spinal fusion for cervical degenerative diseases , 2010, European Spine Journal.

[10]  Y. Matsuyama,et al.  C5 palsy after cervical laminoplasty: a multicentre study. , 2010, The Journal of bone and joint surgery. British volume.

[11]  S. Toh,et al.  Spinal Cord Shift on Magnetic Resonance Imaging at 24 Hours After Cervical Laminoplasty , 2009, Spine.

[12]  K. Hasegawa,et al.  Upper Extremity Palsy Following Cervical Decompression Surgery Results From a Transient Spinal Cord Lesion , 2007, Spine.

[13]  Raj D. Rao,et al.  Bilateral C5 motor paralysis following anterior cervical surgery—a case report , 2006, Clinical Neurology and Neurosurgery.

[14]  J. Golden,et al.  Oligodendrocyte maturation is inhibited by bone morphogenetic protein , 2004, Molecular and Cellular Neuroscience.

[15]  H. Yoshikawa,et al.  C5 Palsy after Decompression Surgery for Cervical Myelopathy: Review of the Literature , 2003, Spine.

[16]  L. Hung,et al.  Relationship of Cervical Spinal Rootlets and the Inferior Vertebral Notch , 2003, Clinical orthopaedics and related research.

[17]  K. Saiki,et al.  Paralysis of the arm after posterior decompression of the cervical spinal cord , 1993, European Spine Journal.

[18]  J. Ruscalleda,et al.  Some aspects of the spinal cord circulation in cervical myelopathy , 1975, Neuroradiology.

[19]  J. Grinspan Bone Morphogenetic Proteins: Inhibitors of Myelination in Development and Disease. , 2015, Vitamins and hormones.

[20]  G. Ling,et al.  Bone morphogenetic protein-2 used in spinal fusion with spinal cord injury penetrates intrathecally and elicits a functional signaling cascade. , 2010, The spine journal : official journal of the North American Spine Society.