From the Research
Introduction to C5 Nerve Root Palsy
C5 (fifth cervical) nerve root palsy is a complication that can occur after cervical spine surgery, characterized by weakness or paralysis of the muscles innervated by the C5 nerve root, including the deltoid and biceps brachii muscles [ 1 ]. This condition can result in significant morbidity and impact the patient's quality of life.
Clinical Features of C5 Palsy
The clinical features of C5 palsy include:
- Weakness or paralysis of the deltoid and/or biceps brachii muscles
- Sensory disturbance or pain in the C5 dermatome
- Hemilateral palsy, with the majority of cases occurring on one side of the body [ 2 ]
- Onset of symptoms typically within a week after surgery
Etiology and Risk Factors
The exact cause of C5 palsy remains unclear, but several theories have been proposed, including:
- Segmental spinal cord disorder theory
- Nerve root injury theory [ 2 ] Risk factors for C5 palsy include:
- Age
- Male gender
- Ossification of the posterior longitudinal ligament
- Stenosis of the C4-C5 intervertebral foramen [ 3 ]
- Postoperative spinal cord shift
- Foraminal stenosis of C4-5 and C5-6 [ 4 ]
Prevention and Treatment
Preventive measures for C5 palsy include:
- Prophylactic foraminotomy to decompress the C5 nerve root
- Intraoperative neuromonitoring
- Avoidance of excessive posterior shift of the spinal cord
- Avoidance of excessive postoperative lordotic alignment of the cervical spine [ 2 ] Treatment for C5 palsy typically involves conservative management, including:
- Physical therapy to maintain range of motion and strength
- Pain management
- Monitoring for resolution of symptoms
Prognosis
The prognosis for C5 palsy is generally good, with the majority of patients experiencing recovery of motor function [ 1 ]. However, the incidence of C5 palsy can be significant, and it is essential to consider the risk factors and take preventive measures to minimize the occurrence of this complication.