Issue release date: 12.11.2024

 
Turkish Neurosurgery 2023 , Vol 33 , Num 1
Preoperatively, Which Parameter Allows Us to Predict the C5 Palsy After Cervical Open-Door Laminoplasty?
Inan UZUNOGLU1,Gokhan GURKAN2,Ilker Deniz CINGOZ3,Murat ATAR4,Ismail KAYA3,Ege COSKUN5,Kazim Ayberk SINCI6,Ezgi Suat BAYRAKTAR6,Koray UR5,Hasan Emre AYDIN7,Ceren KIZMAZOGLU5,Orhan KALEMCI5,Murat SAYIN2,Nurullah YUCEER2
1Health Science University, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Neurosurgery, Ankara, Turkey
2Katip Celebi Unıversity, Ataturk Training and Research Hospital, Department of Neurosurgery, Izmir, Turkey
3Usak University of Health Sciences, Faculty of Medicine, Department of Neurosurgery, Usak, Turkey
4Sultan Abdulhamid Han Training and Research Hospital, Department of Neurosurgery, Istanbul, Turkey
5Dokuz Eylul University, Faculty of Medicine, Department of Neurosurgery Izmir, Turkey
6Katip Celebi Unıversity, Ataturk Training and Research Hospital, Department of Radiology, Izmir, Turkey
7Kutahya Health Science University, Department of Neurosurgery, Kutahya, Turkey DOI : 10.5137/1019-5149.JTN.38560-22.2 AIM: To uncover factors that can predict the development of C5 palsy before surgery by evaluating several different parameters.

MATERIAL and METHODS: A total of 177 patients who underwent surgery between 2015 and 2020 were included in the study. In total, C5 palsy was observed in 22 (12.4%) of our patients. The radiological and clinical data of the patients were retrospectively analyzed and added to the data.

RESULTS: A total of 177 patients who satisfied the criteria were included in the study, among whom 117 (66.1%) and 60 (33.9%) were male and female, respectively. Patients with ossified posterior longitudinal ligament (OPLL) (92; 52.0%) needed surgery the most. C5 palsy developed in 16/92 (17.3%) patients who had surgery for OPLL. This result was statistically significant (p<0.001). However, a significant difference in the postoperative Pavlov ratio was noted between both groups (p=0.027). The foraminal dimensions for the C5 palsy group were significantly lower than those for the non-C5 palsy group.

CONCLUSION: Smaller C5 root foramina diameter measurements were the most important predictive factor for the development of C5 palsy after open-door cervical laminoplasty. Although the pathophysiology remains to be fully understood, ischemia-reperfusion injury supposedly plays a role therein. Keywords : Open-door cervical laminoplasty, OPLL, C5 palsy, Cervical spondylotic myelopathy, C4/5 foramina diameter

Corresponding author : Inan UZUNOGLU, dr_inan_uzunoglu@hotmail.com