Evidence map›Paper›PMID 41645163›Full record

SynthesisBMC musculoskeletal disorders2026

Risk factors for C5 nerve root palsy following posterior cervical spinal canal expansion and reconstruction: a systematic review and meta-analysis.

Renkun Zhao, Dongsheng Yuan, Penghui Li, Peng Zhang, Jiaming Wei, Guoliang Ma, Zhizhuang Wang, Bo Xu, Xiaokuan Qin, Bowen Yang and 3 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Renkun Zhao *Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Dongsheng Yuan *Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Penghui Li *Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Peng ZhangHunan University of Chinese Medicine, Changsha, China.
Jiaming WeiDepartment of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Guoliang MaDepartment of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Zhizhuang WangDepartment of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Bo XuDepartment of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Xiaokuan QinDepartment of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Bowen YangDepartment of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
He YinDepartment of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China. milkywaymoon@163.com.
Kexin YangDepartment of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China. 13611261137@163.com.
Xin ChenDepartment of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China. 15101161150@139.com.

Funding

the National Natural Science Foundation of China 82205151
6 · The paper itself

Abstract

objectiveC5 nerve root palsy is the most common complication following posterior cervical spinal canal expansion and reconstruction, significantly impacting patients’ quality of life. Although several systematic reviews and meta-analyses have explored the risk factors of C5 nerve root palsy, inconsistencies remain in key conclusions such as the role of age and C4-5 intervertebral foramen stenosis, and new clinical evidence published in recent years has not been integrated. This meta-analysis aims to evaluate the incidence and risk factors of C5 nerve root palsy after posterior cervical spinal canal expansion and reconstruction, providing a more precise and generalizable basis for clinical screening of high-risk patients and formulation of preventive interventions.

methodsCase-control trials on C5 nerve root palsy following posterior cervical spinal canal expansion and reconstruction were retrieved from PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang databases. The search period spanned from each database’s inception to November 2025. Search strategies were tailored to each database’s characteristics. We extracted the basic characteristics of included studies, the incidence of C5 nerve root palsy symptoms, and associated risk factors. Included studies underwent risk of bias assessment and quality evaluation. Meta-analysis was performed using Stata 18.0 to assess the incidence and risk factors of C5 nerve root palsy symptoms.

results(1) Seventeen studies were included, involving a total sample size of 2,995 cases. The incidence of axial symptoms was 14% (95%CI: 0.10, 0.17), with 15 studies meeting higher quality standards; (2) Meta-analysis results indicated that advanced age (OR = 2.71, 95%CI: 1.53 ~ 3.88)、male gender (OR = 0.36, 95%CI: 0.03 ~ 0.68)、narrowing of the C4-5 intervertebral foramen width (OR=-0.61, 95%CI: -0.84 ~ 0.38)、changes in cervical curvature (OR = 2.88, 95%CI: 1.90 ~ 3.86)、increased spinal cord retraction distance (OR = 0.72, 95%CI: 0.57 ~ 0.87) and high signal intensity on T2-weighted MRI at the C4-5 spinal cord segment (OR = 0.93, 95%CI: 0.16 ~ 1.69) were identified as independent risk factors for C5 nerve root paralysis symptoms.

conclusionAdvanced age, male gender, narrowing of the C4-5 intervertebral foramen width, changes in cervical curvature, increased spinal cord retraction distance, and high signal intensity on T2-weighted MRI at the C4-5 spinal cord segment are independent risk factors for C5 nerve root palsy symptoms. Patients with these high-risk factors require close follow-up and timely intervention to reduce the incidence of C5 nerve root palsy symptoms and improve their quality of life.

Indexed as

Cervical VertebraeParalysisPlastic Surgery ProceduresPostoperative ComplicationsRadiculopathySpinal CanalSpinal Nerve RootsHumansIncidenceRisk FactorsC5 nerve root palsyMeta-analysisPosterior cervical spinal canal expansion and reconstructionRisk factorsThe incidence

Identifiers

PMID41645163
PMCPMC12882495

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.