Analysis of the Postoperative Palsy of Upper Extremities of the Cases undergone Spinous Process-Splitting Laminoplasty without Foraminotomy

Abstract

Dysfunction of the C5 nerve root, called C5 palsy, has been known as one of the complications after cervical spinal surgeries. Adding foraminotomy or not, to prevent this mechanical hidden complication remains controversial.In our institute, from 1996 to 2001, spinous process-splitting laminoplasty without foraminotomy was performed in the treatment of a total of 126 patients with cervical spinal cord compression. 94 cases were diagnosed as cervical spondylosis, 33 cases as narrow canal and 41 cases as ossification of the longitudinal ligament. Most of the stenotic lesions were shown from C4 to C6. In 97 patients, numbness of the upper extremities was recognized preoperatively. In 20 patients, pain was recognized and in 51 paresis. After the cervical surgery without foraminotomy, only 7 cases developed complications of the upper extremities and particularly paresis in one(0.8%). These complications disappeared within at least one month.These results seem to suggest that foraminotomy is not necessary to prevent dysfunction of the cervical nerve root.