• S Imagama, Y Matsuyama, Y Yukawa, N Kawakami, M Kamiya, T Kanemura, N Ishiguro, and Nagoya Spine Group.
• Department of Orthopaedic Surgery, Nagoyal University Graduate School of Medicine, 65 Turumai, Showa-ku, Nagoya 466-8550, Japan. Imagama@med.nagoya-u.ac.jp
• J Bone Joint Surg Br. 2010 Mar 1; 92 (3): 393-400.

AbstractWe have reviewed 1858 patients who had undergone a cervical laminoplasty and identified 43 (2.3%) who had developed a C5 palsy with a MMT (MRC) grade of 0 to 2 in the deltoid, with or without involvement of the biceps, but with no loss of muscular strength in any other muscles. The clinical features and radiological findings of patients with (group P; 43 patients) and without (group C; 100 patients) C5 palsy were compared. CT scanning of group P revealed a significant narrowing of the intervertebral foramen of C5 (p < 0.005) and a larger superior articular process (p < 0.05). On MRI, the posterior shift of the spinal cord at C4-5 was significantly greater in group P, than in group C (p < 0.01). This study is the first to correlate impairment of the C5 nerve root with a C5 palsy. It may be that early foraminotomy in susceptible individuals and the avoidance of tethering of the cord by excessive laminoplasty may prevent a post-operative palsy of the C5 nerve root.

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