Recovery patterns from C5 palsy after anterior cervical decompression and fusion, posterior cervical decompression and fusion, and laminoplasty for degenerative cervical myelopathy: systematic review and meta-analysis of 748 C5 palsy cases.

IF 2.7 Q2 ORTHOPEDICS

Asian Spine Journal Pub Date : 2025-08-11 DOI:10.31616/asj.2025.0012

Vibhu Krishnan Viswanathan, Guna Pratheep Kalanchiam, Akilan Chinnappan, Sathish Muthu

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Abstract

Despite the favorable postoperative prognosis of C5 palsy (C5P), a certain proportion of these patients have less satisfactory outcomes. The current systematic review and meta-analysis thus aimed to comprehensively evaluate existing literature and identify the onset, recovery patterns, and outcomes of C5P following diverse surgical approaches. Five different databases (Google Scholar, Embase, PubMed, Web of Science, and Cochrane Library) were thoroughly searched for relevant literature on October 15, 2024. Studies reporting on incidences of C5P following surgery for degenerative cervical conditions with recovery data published until 2024 were scrutinized. Narrative or systematic reviews, opinions, letters to the editor, and manuscripts published in non-English languages were excluded. A total of 30 articles involving 8,116 patients who underwent undergoing surgery for degenerative cervical myelopathy with 748 reported C5P cases were included for analysis. The overall time to palsy reported in the included studies was 3 days (95% confidence interval [CI], 2.56-3.60). Palsy occurred earliest with anterior cervical decompression and fusion (ACDF) at 2 days (95% CI, 0.35-4.54), followed by laminoplasty (LP) at 3.2 days (95% CI, 2.02-4.34) and posterior cervical decompression and fusion (PCDF) at 3.6 days (95% CI, 2.81-4.37). Patients with palsy showed improved recovery with time. At the 1-year follow-up, the reported recovery rates were 100%, 52.9%, and 50% for ACDF, LP, and PCDF, respectively. C5P demonstrated a delayed presentation, with mean onset of 3 days after surgery, which can range from 2 days for ACDF to 3.6 days for PDCF. Recovery improved progressively with time and varied for different surgical procedures, with ACDF showing the best recovery and PDCF for cervical myelopathy showing the poorest recovery.

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颈椎前路减压融合、后路减压融合和椎板成形术治疗退行性颈椎病后C5麻痹的恢复模式：748例C5麻痹病例的系统回顾和荟萃分析

尽管C5性麻痹（C5P）术后预后良好，但一定比例的患者预后不太满意。因此，当前的系统综述和荟萃分析旨在全面评估现有文献，确定不同手术入路后C5P的发病、恢复模式和预后。在2024年10月15日，我们对b谷歌Scholar、Embase、PubMed、Web of Science和Cochrane Library这5个不同的数据库进行了全面的文献检索。研究报告了退行性宫颈疾病手术后C5P的发生率，并公布了到2024年的恢复数据。叙述性或系统性的评论、观点、给编辑的信件和以非英语语言发表的手稿被排除在外。共纳入30篇文章，涉及8,116例行退行性颈椎病手术的患者，其中748例报道了C5P病例。纳入研究中报告的瘫痪总时间为3天（95%可信区间[CI]， 2.56-3.60）。前路颈椎减压融合术（ACDF）在第2天发生瘫痪最早（95% CI, 0.35-4.54），其次是椎板成形术（LP）在第3.2天（95% CI, 2.02-4.34），后路颈椎减压融合术（PCDF）在第3.6天（95% CI, 2.81-4.37）。随着时间的推移，麻痹患者的恢复情况有所改善。随访1年时，ACDF、LP和PCDF的恢复率分别为100%、52.9%和50%。C5P表现为延迟表现，平均在手术后3天发病，ACDF为2天，PDCF为3.6天。随着时间的推移，恢复逐渐改善，不同手术方式的恢复有所不同，ACDF表现出最好的恢复，PDCF表现出最差的恢复。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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