Anterior Corpectomy Versus Posterior Laminoplasty- Is the Risk of Postoperative C5 Palsy Different?

Nathan Christopher Rowland, MD1, Jau-ching Wu, MD1, Gurpreet Gandhoke, MD1

1San Francisco, CA United States

Keywords: nerve root, outcome, cervical diskectomy, laminectomy, corpectomy

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Abstract

     Both anterior cervical corpectomy and fusion (ACCF) and laminoplasty are effective treatments for selected cases of cervical stenosis. Post-operative C5 palsies may occur with either anterior or posterior decompressive procedures, however a direct comparison of C5 palsy rates between the two approaches is not present in the literature.
     We sought to compare the C5 palsy rate of ACCF versus laminoplasty.
     The demographics of the groups were similar except for age (ACCF group mean age of 53 yrs versus laminoplasty group mean age of 62 yrs, p = 0.002).
     We conducted a retrospective review of 31 ACCF (at C4 or C5) and 31 instrumented laminoplasty cases performed to treat cervical stenosis. The mean number of levels treated was higher in the laminoplasty cohort (3.87) compared to the ACCF cohort (2.74, p < 0.001). The mean preoperative Nurick score of the laminoplasty cohort (2.61) was higher than the mean preoperative Nurick score of the ACCF cohort (1.10, p < 0.001).
     The overall clinical follow up rate was 100%. Mean overall clinical follow up was 14 months. There were no significant differences in the EBL or LOS between the 2 groups (p < 0.05). There was no statistical difference between the complication or reoperation rates between the two groups (p = 0.184 and p = 0.238). There were two C5 nerve root pareses in each group. Three of the four patients recovered full deltoid function, and the fourth patient recovered nearly full deltoid function at final follow up. There was no statistical difference in the rate of deltoid paresis (6.5%) between the 2 groups (p = 1).
     This is a retrospective study.
     Both ACCF and laminoplasty are effective treatments for patients with cervical stenosis.
     We found no difference in the rate of deltoid paresis between ACCF and laminoplasty to treat cervical stenosis.


Acknowledgements

Project Roles:

N. Rowland (), J. Wu (), G. Gandhoke ()