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Spinal cord rotation may be indicator of postoperative C5 palsy
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Spinal cord rotation greater than 6° seen preoperatively on MRI may be a strong indicator that the patient will develop a postoperative C5 palsy following posterior cervical decompression surgery, according to the results of a recently published retrospective study.
Researchers reviewed records of 72 patients who underwent posterior cervical decompression and 77 patients who underwent anterior cervical decompression. Patients who underwent anterior decompression formed the control group.
On the patients’ preoperative MRI scans the researchers noted the spinal cord rotation and anterior-posterior diameter. Overall, the average amount of rotation was 3.83° ± 2.47° and 3.45° ± 2.23° for the anterior and posterior groups, respectively. Researchers also classified the spinal cord rotation as mild (less than 6°), moderate (6° to 10°) and severe (more than 11°).
Researchers found 7.3% of patients developed C5 palsy. Among the patients with C5 palsy in the posterior group, 2 patients had mild rotation, 4 patients had moderate rotation and 1 patient had severe rotation.
There was also a significant association between the severity of preoperative spinal cord rotation and the postoperative development of C5 palsy in the anterior and posterior groups. Based on a logistic regression analysis performed to determine if cord rotation was an independent risk factor for C5 palsy, the researchers found odds ratios of 2.90 (P < .05) and 3.42 (P < .05) for the anterior and posterior groups, respectively.
Furthermore, the researchers noted patients with C5 palsy are more likely to be in the moderate or severe rotation group than the mild rotation group. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.
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