Factors associated with postoperative C5 palsy after expansive open-door laminoplasty: retrospective cohort study using multivariable analysis

Takashi Tsuji, Morio Matsumoto, Masaya Nakamura, Ken Ishii, Nobuyuki Fujita, Kazuhiro Chiba, Kota Watanabe
European Spine Journal 2017, 26 (9): 2410-2416

PURPOSE: The aim of the present study was to investigate the factors associated with C5 palsy by focusing on radiological parameters using multivariable analysis.

METHODS: The authors retrospectively assessed 190 patients with cervical spondylotic myelopathy treated by open-door laminoplasty. Four radiographic parameters-the number of expanded lamina, C3-C7 angle, lamina open angle and space anterior to the spinal cord-were evaluated to clarify the factors associated with C5 palsy.

RESULTS: Of the 190 patients, 11 developed C5 palsy, giving an overall incidence of 5.8%. Although the number of expanded lamina, lamina open angle and space anterior to the spinal cord were significantly larger in C5 palsy group than those in non-palsy group, a multiple logistic regression analysis revealed that only the space anterior to the spinal cord (odds ratio 2.60) was a significant independent factor associated with C5 palsy. A multiple linear regression analysis indicated that the lamina open angle was associated with the space anterior to the spinal cord and the analysis identified the following equation: space anterior to the spinal cord (mm) = 1.54 + 0.09 × lamina open angle (degree). A cut-off value of 53.5° for the lamina open angle predicted the development of C5 palsy with a sensitivity of 72.7% and a specificity of 83.2%.

CONCLUSIONS: The larger postoperative space anterior to the spinal cord, which was associated with the lamina open angle, was positively correlated with the higher incidence of C5 palsy.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.