PDF(Pubmed)
Abstract：
UNASSIGNED: Postoperative C5 palsy is a common complication of laminoplasty for cervical ossification of the posterior longitudinal ligament (C-OPLL), although there are several hypotheses regarding its etiology, the exact pathomechanism for this undesirable event remain unclear. The aim of this study was to review clinical and imaging findings in patients with C5 palsy and to propose potential risk factors for this complication.
UNASSIGNED: A total of 220 consecutive patients who had undergone posterior spinal process-splitting laminoplasty (pSPSL) for C-OPLL between January 2018 and December 2019 were included in this study. Postoperative C5 palsy was defined as deltoid muscle weakness of a grade ≤3 in manual muscle test (MMT). These patients were divided into two groups based on the postoperative development of C5 palsy: patients with C5 palsy (group A) and those without C5 palsy (group B). The clinical and imaging covariates evaluated were age, sex, OPLL type, K-line, foraminal stenosis, gutter malposition, and preoperative spinal cord signal change. Logistic regression was used to analyze the independent risk factors for C5 palsy.
UNASSIGNED: In total, 211 patients (18 in group A and 193 in group B) were enrolled in this study, and the incidence of C5 palsy was 8.53%. Sixteen patients had a MMT of grade 3 and two had an MMT of grade ≤2. During the follow-up period (mean duration: 25.10±6.67 months), the MMT grade rose to 5 in 16 patients, 4 in one patient, and 3 in one patient. Multivariate analysis revealed that malposition of the bony gutter [odds ratio (OR) 11.073, 95% confidence interval (CI): 3.411, 35.948; P<0.001] and C4/5 intervertebral foramen stenosis (OR 8.455, 95% CI: 2.559, 27.936; P<0.001) were independent risk factors for C5 palsy.
UNASSIGNED: The incidence of C5 palsy was 8.53% among patients undergoing pSPSL for C-OPLL. Gutter malposition and C4/5 intervertebral foramen stenosis were identified as risk factors for this complication.
UNASSIGNED: A total of 220 consecutive patients who had undergone posterior spinal process-splitting laminoplasty (pSPSL) for C-OPLL between January 2018 and December 2019 were included in this study. Postoperative C5 palsy was defined as deltoid muscle weakness of a grade ≤3 in manual muscle test (MMT). These patients were divided into two groups based on the postoperative development of C5 palsy: patients with C5 palsy (group A) and those without C5 palsy (group B). The clinical and imaging covariates evaluated were age, sex, OPLL type, K-line, foraminal stenosis, gutter malposition, and preoperative spinal cord signal change. Logistic regression was used to analyze the independent risk factors for C5 palsy.
UNASSIGNED: In total, 211 patients (18 in group A and 193 in group B) were enrolled in this study, and the incidence of C5 palsy was 8.53%. Sixteen patients had a MMT of grade 3 and two had an MMT of grade ≤2. During the follow-up period (mean duration: 25.10±6.67 months), the MMT grade rose to 5 in 16 patients, 4 in one patient, and 3 in one patient. Multivariate analysis revealed that malposition of the bony gutter [odds ratio (OR) 11.073, 95% confidence interval (CI): 3.411, 35.948; P<0.001] and C4/5 intervertebral foramen stenosis (OR 8.455, 95% CI: 2.559, 27.936; P<0.001) were independent risk factors for C5 palsy.
UNASSIGNED: The incidence of C5 palsy was 8.53% among patients undergoing pSPSL for C-OPLL. Gutter malposition and C4/5 intervertebral foramen stenosis were identified as risk factors for this complication.
摘要：
■术后C5麻痹是颈椎后纵韧带骨化（C-OPLL）椎板成形术的常见并发症，尽管关于其病因有几个假设，这一不良事件的确切病理机制尚不清楚.这项研究的目的是回顾C5麻痹患者的临床和影像学表现，并提出这种并发症的潜在危险因素。
共有220例连续患者在2018年1月至2019年12月期间接受了C-OPLL后路脊柱突劈开椎板成形术（pSPSL）。术后C5麻痹被定义为手动肌肉测试（MMT）中≤3级的三角肌无力。根据C5麻痹的术后发展将这些患者分为两组：C5麻痹患者（A组）和无C5麻痹患者（B组）。评估的临床和影像学协变量为年龄，性别,OPLL类型,K线,椎间孔狭窄,排水沟错位,术前脊髓信号改变。采用Logistic回归分析C5麻痹的独立危险因素。
■总共，211例患者（A组18例，B组193例）纳入本研究，C5麻痹的发生率为8.53%。16名患者的MMT为3级，2名患者的MMT≤2级。在随访期间（平均持续时间：25.10±6.67个月），16名患者的MMT等级上升到5级，4在一个病人中，3在一个病人。多因素分析显示，骨沟错位[比值比（OR）11.073，95％置信区间（CI）：3.411，35.948；P<0.001]和C4/5椎间孔狭窄（OR8.455，95％CI：2.559，27.936；P<0.001）是C5麻痹的独立危险因素。
■在接受pSPSL治疗C-OPLL的患者中，C5麻痹的发生率为8.53％。沟错位和C4/5椎间孔狭窄被确定为该并发症的危险因素。
共有220例连续患者在2018年1月至2019年12月期间接受了C-OPLL后路脊柱突劈开椎板成形术（pSPSL）。术后C5麻痹被定义为手动肌肉测试（MMT）中≤3级的三角肌无力。根据C5麻痹的术后发展将这些患者分为两组：C5麻痹患者（A组）和无C5麻痹患者（B组）。评估的临床和影像学协变量为年龄，性别,OPLL类型,K线,椎间孔狭窄,排水沟错位,术前脊髓信号改变。采用Logistic回归分析C5麻痹的独立危险因素。
■总共，211例患者（A组18例，B组193例）纳入本研究，C5麻痹的发生率为8.53%。16名患者的MMT为3级，2名患者的MMT≤2级。在随访期间（平均持续时间：25.10±6.67个月），16名患者的MMT等级上升到5级，4在一个病人中，3在一个病人。多因素分析显示，骨沟错位[比值比（OR）11.073，95％置信区间（CI）：3.411，35.948；P<0.001]和C4/5椎间孔狭窄（OR8.455，95％CI：2.559，27.936；P<0.001）是C5麻痹的独立危险因素。
■在接受pSPSL治疗C-OPLL的患者中，C5麻痹的发生率为8.53％。沟错位和C4/5椎间孔狭窄被确定为该并发症的危险因素。
