Die C5-Parese nach multisegmentaler zervikaler Dekompression: Wie kann diese vermieden werden?

Background: Anterior cervical discectomy and fusion (ACDF) as well as posterior instrumentation of the cervical spine are frequently performed surgeries for cervical disc prolapse or spinal stenosis. Surgery itself harbors a very low risk of adverse events. Postoperative palsy of the C5 nerve root, however, is a severe complication and its origin is still not fully understood. The risk of such a C5 palsy is reported to be between 0 and 30%; 5% on average according to the literature. Objectives: To describe underlying pathomechanisms and to recommend strategies for risk reduction. Materials and methods: An extensive literature research via Medline was performed. Results: Potential risk factors are male gender, sagittal diameter below 5.6 mm, anterior approach, and higher age. Conclusions: Currently available data only originates from retrospective or anatomical studies. A prospective register study with the goal to put light on the pathogenesis is currently being performed.