C5 palsy after cervical laminoplasty A MULTICENTRE STUDY

被引:256
作者
Imagama, S. [1 ]
Matsuyama, Y. [1 ]
Yukawa, Y. [1 ]
Kawakami, N. [1 ]
Kamiya, M. [1 ]
Kanemura, T. [1 ]
Ishiguro, N. [1 ]
机构
[1] Nagoya Univ, Grad Sch Med, Nagoya, Aichi 4648601, Japan
来源
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME | 2010年 / 92B卷 / 03期
关键词
SEGMENTAL MOTOR PARALYSIS; SPONDYLOTIC MYELOPATHY; EXPANSIVE LAMINOPLASTY; SURGICAL-TREATMENT; DOOR LAMINOPLASTY; DECOMPRESSION; RADICULOPATHY; OSSIFICATION; SURGERY; SPINE;
D O I
10.1302/0301-620X.92B3.22786
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
We have reviewed 1858 patients who had undergone a cervical laminoplasty and identified 43 (2.3%) who had developed a C5 palsy with a MMT (MRC) grade of 0 to 2 in the deltoid, with or without involvement of the biceps, but with no loss of muscular strength in any other muscles. The clinical features and radiological findings of patients with (group P; 43 patients) and without (group C; 100 patients) C5 palsy were compared. CT scanning of group P revealed a significant narrowing of the intervertebral foramen of C5 (p < 0.005) and a larger superior articular process (p < 0.05). On MRI, the posterior shift of the spinal cord at C4-5 was significantly greater in group P, than in group C (p < 0.01). This study is the first to correlate impairment of the C5 nerve root with a C5 palsy. It may be that early foraminotomy in susceptible individuals and the avoidance of tethering of the cord by excessive laminoplasty may prevent a post-operative palsy of the C5 nerve root.
引用
收藏
页码:393 / 400
页数:8
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