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, Koota Watanabe

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5 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalEuropean Spine Journal
DOIs
Publication statusAccepted/In press - 2017 Jul 21

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Paralysis
Cohort Studies
Retrospective Studies
Spinal Cord
Regression Analysis
Spinal Cord Diseases
Incidence
Laminoplasty
Linear Models
Logistic Models
Odds Ratio

Keywords

  • C5 palsy
  • Cervical laminoplasty
  • Lamina open angle
  • Space anterior to the spinal cord

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{746a14bec2244438a0cbeb1271f5752b,
title = "Factors associated with postoperative C5 palsy after expansive open-door laminoplasty: retrospective cohort study using multivariable analysis",
abstract = "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.",
keywords = "C5 palsy, Cervical laminoplasty, Lamina open angle, Space anterior to the spinal cord",
author = "Takashi Tsuji and Morio Matsumoto and Masaya Nakamura and Ken Ishii and Nobuyuki Fujita and Kazuhiro Chiba and Koota Watanabe",
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language = "English",
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T1 - Factors associated with postoperative C5 palsy after expansive open-door laminoplasty

T2 - retrospective cohort study using multivariable analysis

AU - Tsuji, Takashi

AU - Matsumoto, Morio

AU - Nakamura, Masaya

AU - Ishii, Ken

AU - Fujita, Nobuyuki

AU - Chiba, Kazuhiro

AU - Watanabe, Koota

PY - 2017/7/21

Y1 - 2017/7/21

N2 - 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.

AB - 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.

KW - C5 palsy

KW - Cervical laminoplasty

KW - Lamina open angle

KW - Space anterior to the spinal cord

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