颈椎术后C5麻痹与非C5麻痹的比较研究

IF 0.4 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management Pub Date : 2025-03-27 DOI:10.1016/j.inat.2025.102019

Kosuke Fukuzawa, Masashi Uehara, Shota Ikegami, Yoshinari Miyaoka, Hiroki Oba, Terue Hatakenaka, Daisuke Kurogochi, Takuma Fukuzawa, Shinji Sasao, Keisuke Shigenobu, Tetsuhiko Mimura, Jun Takahashi

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引用次数: 0

摘要

目的：5麻痹是已知的颈椎手术后并发症，尽管文献中发病率从0%到30%不等。C5麻痹的病因仍然未知，许多研究描述了相互矛盾的危险因素。本比较研究旨在阐明颈椎手术患者C5麻痹的发生率和危险因素。方法收集连续433例患者的医疗资料，其中男性305例，女性128例；平均年龄：67.7岁)对首次颈椎手术患者进行回顾性研究。将队列分为C5麻痹组和非C5麻痹组，通过多因素分析检查相关因素。结果433例患者中57例（13.2%）术后出现C5麻痹。寰枢椎半脱位（AAS）在C5麻痹组（10.5%）明显高于非C5麻痹组（3.7%）（p = 0.035）。关于手术细节，包括C4-5的手术范围在C5麻痹组中更为常见（80.7%比63.8%,p = 0.015）。多因素分析显示，男性与C5型麻痹有显著相关性（p = 0.025）， AAS (p <；0.001)，手术范围包括C4-5 （p = 0.002）。结论颈椎手术患者发生c5麻痹的比例为13.2%。与男性性别、AAS和手术范围（包括C4-5）相关的显著相关性提示此类患者围手术期需要额外考虑。

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Comparative study of cases with and without C5 palsy after cervical spine surgery

Objective

C5 palsy is a known complication after cervical spine surgery, although incidence rates range widely from 0 to 30% in the literature. The causes of C5 palsy also remain unknown, with many studies describing contradictory risk factors. This comparative investigation sought to clarify the incidence and risk factors of C5 palsy in patients receiving cervical spine surgery.

Methods

The medical data of 433 consecutive patients (305 male and 128 female; mean age: 67.7 years) who underwent their first cervical spine surgery were retrospectively examined. The cohort was divided into the C5 palsy group and the non-C5 palsy group, and associated factors were examined by multivariate analysis.

Results

Postoperative C5 palsy was observed in 57 of 433 (13.2 %) patients. Atlantoaxial subluxation (AAS) was significantly more common in the C5 palsy group (10.5 %) than in the non-C5 palsy group (3.7 %) (p = 0.035). Regarding procedural details, surgical range including C4-5 was significantly more common in the C5 palsy group (80.7 % vs. 63.8 %, p = 0.015). Multivariate analysis revealed significant associations with C5 palsy for male gender (p = 0.025), AAS (p < 0.001), and surgical range including C4-5 (p = 0.002).

Conclusion

C5 palsy occurred in 13.2% of patients undergoing cervical spine surgery. Significant associations with male gender, AAS, and surgical range including C4-5 suggest the need for additional perioperative considerations in such patients.

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