Risk Factor Analysis for C5 Palsy after Double-Door Laminoplasty for Cervical Spondylotic Myelopathy

Satoshi Baba; Ko Ikuta; Hiroko Ikeuchi; Makoto Shiraki; Norihiro Komiya; Takahiro Kitamura; Hideyuki Senba; Satoshi Shidahara

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자료유형: 학술저널

저자정보: Satoshi Baba (Karatsu Red Cross Hospital) Ko Ikuta (Karatsu Red Cross Hospital) Hiroko Ikeuchi (Karatsu Red Cross Hospital) Makoto Shiraki (Karatsu Red Cross Hospital) Norihiro Komiya (Karatsu Red Cross Hospital) Takahiro Kitamura (Karatsu Red Cross Hospital) Hideyuki Senba (Karatsu Red Cross Hospital) Satoshi Shidahara (Karatsu Red Cross Hospital)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.10 No.2

발행연도: 2016.1

수록면: 298 - 308 (11page)

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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.

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