Abstract：Objective This study aims to explore the influence of different factors of C5 nerve root paralysis after posterior cervical laminoplasty for ossification of posterior longitudinal ligament. Methods A retrospective analysis was performed from January 2013 to October 2017 on 132 patients with ossification of the posterior longitudinal ligament treated with posterior cervical laminoplasty in Xuzhou Central Hospital. Participants were composed of 68 male and 64 female patients aged 39 to 79 years, with an average age of (58.6±8.8) years. The study included 31 segmental, 40 continuous, and 61 mixed cases. Patients were divided into palsy (13 cases) and nonparalysis (119 cases) groups. Baseline data of the two groups were compared and analyzed. Japanese Orthopedic Association (JOA) score was performed before surgery and 1 month after surgery. Pre- and postoperative cervical curvatures and cervical curvature index (CCI) were measured. Types of cervical ossification and changes in C3/4 or C4/5 MRI spinal cord signals were examined between groups. Results Differences between the two groups in terms of age, gender, and ossification type were insignificant (all P values >0.05). Differences in the JOA score and postoperative improvement rate between groups before and 1 month after surgery were insignificant (all P values >0.05). However, changes in the cervical curvature before and after operation of the paralytic group were 5.02°±6.53°, which was higher than that in the nonparalytic group (1.21°±6.58°). The CCI of patients with paralysis before and after operation was 5.59%±7.38%, which was higher than that of patients without paralysis (1.35%±5.65%). Differences were statistically significant (t=-1.98, -2.49; all P values<0.05). The proportion of patients with C3/4 or C4/5 preoperative spinal cord signal changes in the MRI of the nonparalytic group (20/119) was less than that of the paralytic group (7/13), and the difference was statistically significant (χ2=7.74,P=0.005). Conclusions ignificant pre- and postoperative changes in cervical curvature and CCI as well as changes in spinal cord signals shown in the C3/4 or C4/5 MRI may influence the occurrence of C5 nerve root palsy after posterior cervical laminoplasty for ossification of the posterior longitudinal ligament.
常步青, 马超, 陶友伦, 郝云甲, 范家强, 张述才, 张在轶, 王爱国. 后纵韧带骨化症颈后路椎管成形术后C5神经根麻痹的临床分析[J]. 中华解剖与临床杂志, 2022, 27(11): 780-785.
Chang Buqing, Ma Chao, Tao Youlun, Hao Yunjia, Fan Jiaqiang, Zhang Shucai, Zhang Zaiyi, Wang Aiguo. Risk factors of C5 nerve root palsy after laminoplasty in patients with ossification of posterior longitudinal ligament. Chinese Journal of Anatomy and Clinics, 2022, 27(11): 780-785.
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