ReviewGlobal spine journal2019
Factors Associated With C5 Palsy Following Cervical Spine Surgery: A Systematic Review.
Review in Global spine journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prophylactic C4/5 foraminotomy for the prevention of C5 palsy following posterior cervical decompression: a systematic review and meta-analysis.Systematic reviews · 2026Pooled it
- Virtual reality-assisted rehabilitation for postoperative C5 palsy: a pilot exploratory randomized controlled trial.Journal of neuroengineering and rehabilitation · 2025Trial
- Article
- Incidence and prognostic factors of postoperative C5 palsy after cervical OPLL surgery: a nationwide prospective multicenter study.Scientific reports · 2026Article
- Incidence of C5 palsy in anterior cervical decompression & fusion, posterior cervical decompression & fusion and laminoplasty for degenerative cervical myelopathy: systematic review and meta-analysis of 21,231 cases.Asian spine journal · 2026Article
- Experimental Development and Internal Validation of a Clinical Prediction Model for the Occurrence of Idiopathic C5 Palsy after Laminoplasty.Neurologia medico-chirurgica · 2026Article
- The relative spinal cord float back distance might be associated with C5 palsy after posterior cervical decompression.Frontiers in surgery · 2026Article
- Clinical efficacy of modified laminoplasty in the treatment of cervical spondylotic myelopathy.BMC musculoskeletal disorders · 2025Article
- Phrenic Nerve Palsy in Anterior Cervical Discectomy and Fusion: Rare as Hen's Teeth.Journal of orthopaedic case reports · 2025Article
- Delayed Post-Operative C5 Palsy After Reduction of Unilateral Cervical Facet Dislocation: A Case Report.Cureus · 2025Article
- Treatment of C5 Palsy: An International Survey of Peripheral Nerve Surgeons.Global spine journal · 2024Article
- Magnetic Resonance Imaging-CCCFLS Scoring System: Toward Predicting Clinical Symptoms and C5 Paralysis.Global spine journal · 2024Article
- A Risk Calculator for the Prediction of C5 Nerve Root Palsy After Instrumented Cervical Fusion.World neurosurgery · 2022Article
- Article
- Application of Neurite Orientation Dispersion and Density Imaging to Evaluate and Predict the Surgical Outcome for Degenerative Cervical Myelopathy.Orthopaedic surgery · 2022Article
- Article
- Analysis of risk factors for C5 nerve root paralysis after posterior cervical decompression.BMC musculoskeletal disorders · 2021Article
- Morphometric analysis of cervical interlaminar space for posterior surgical approach and decompression.Surgical and radiologic anatomy : SRA · 2021Article
- Posterior endoscopic cervical foramiotomy and discectomy: clinical and radiological computer tomography evaluation on the bony effect of decompression with 2 years follow-up.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021Article
- Phrenic nerve palsy after cervical laminectomy and fusion.North American Spine Society journal · 2020Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designSystematic review.
objectivesC5 palsy (C5P) is a not uncommon and disabling postoperative complication with a reported incidence varying between 0% and 30%. Among others, one explanation for its occurrence includes foraminal nerve root tethering. Although different risk factors have been reported, controversy about its causation and prevention persists. Inconsistent study findings contribute to the persistent ambiguity leading to an assumption of a multifactorial nature of the underlying C5P pathophysiology. Here, we report the results of a systematic review on C5P with narrow inclusion criteria in the hope of elucidating risk factors for C5P due to a common pathophysiological mechanism.
methodsElectronic databases from inception to March 9, 2019 and references of articles were searched. Narrow inclusion criteria were applied to identify studies investigating demographic, clinical, surgical, and radiographic factors associated with postoperative C5P.
resultsSixteen studies were included after initial screening of 122 studies. Eighty-four risk factors were analyzed; 27 in ≥2 studies and 57 in single studies. The pooled prevalence of C5P was 6.0% (range: 4.2%-24.1%) with no consistent evidence that C5P was associated with demographic, clinical, or specific surgical factors. Of the radiographic factors assessed, specifically decreased foraminal diameter and preoperative cord rotation were identified as risk factors for C5P.
conclusionAlthough risk factors for C5P have been reported, ambiguity remains due to potentially multifactorial pathophysiology and study heterogeneity. We found foraminal diameter and cord rotation to be associated with postoperative C5P occurrence in our meta-analysis. These findings support the notion that factors contributing to, and acting synergistically with foraminal stenosis increase the risk of postoperative C5P.
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