From the Research
Introduction to C5 Palsy
C5 palsy is a known complication following cervical spine surgery, with its cause remaining unclear and reports on prognosis and risk factors often conflicting 1, 2, 3, 4, 5.
Frequency of C5 Palsy
The frequency of C5 palsy after spinal surgery varies, with studies indicating it can occur in a significant portion of patients undergoing cervical laminectomy or other spinal surgeries 1, 2, 3, 4, 5.
Risk Factors for C5 Palsy
Several risk factors have been identified, including:
- Male gender 2, 4, 5
- Ossification of the posterior longitudinal ligament (OPLL) 3, 5
- Narrower intervertebral foramen 3, 5
- Laminectomy 3, 5
- Excessive spinal cord drift 5
- Instrumentation caudal to C5 in operations addressing degenerative cervical pathology 1
Treatment and Prognosis
Treatment for C5 palsy may involve observation, physical therapy, or in some cases, further surgical intervention. The overall prognosis for C5 palsy is generally good, with many patients experiencing spontaneous resolution of symptoms 1, 2, 3.
Considerations for Healthcare Providers
Healthcare providers should be aware of the potential for C5 palsy after spinal surgery and consider the risk factors when planning operative procedures. Patients should be educated on the risks and monitored closely postoperatively for signs of C5 palsy 1, 2, 3, 4, 5.
Differential Diagnosis and Caveats
A differential diagnosis should include other potential causes of neurological deficits, such as infection, hematoma, or hardware failure. Healthcare providers should also be cautious when interpreting the results of studies on C5 palsy, as the incidence and risk factors may vary depending on the specific surgical procedure and patient population 1, 2, 3, 4, 5.