The Correlation Study of C5 Nerve Palsy after Anterior Cervical Decompression and Fusion：A Retrospective Study

Background: Anterior cervical decompression and fusion (ACDF) is the gold standard surgical treatment for cervical degenerative disease. Postoperative C5 nerve root palsy is a known complication following cervical spine surgery. The etiology of postoperative C5 nerve root palsy remains unknown. This study was performed to determine the characteristics that may predict a risk of developing C5 palsy in patients following anterior cervical decompression and fusion (ACDF) as measured by cervical vertebral lateral radiography and magnetic resonance imaging (MRI). Methods: : Radiographic parameters were measured by cervical vertebral lateral radiography and magnetic resonance imaging (MRI) and recorded. The anteroposterior diameter (APD), left and right ipsilateral foraminal diameters, and left and right cord-lamina angles were measured on preoperative MRI of the cervical vertebra and recorded. Additionally, we measured two parameters on preoperative and postoperative (within 2 weeks of the procedure) lateral plain-film radiographs: the cervical spine angle and cervical lordosis. Results: : 21 patients with C5 nerve palsy and 175 controls were identified. There were no baseline differences in the left and right foraminal diameters. The APD, left and right cord-lamina angles, and cervical curvature correction were significantly different between the two groups ( P < 0.05). Conclusions: : For patients with ACDF, a smaller APD and excessive cervical curvature are correlated with C5 palsy. Excessive reconstruction of cervical curvature should not be performed in patients with preoperative foraminal narrowing.