Wang Tao, Wang Hui, Liu Sen, Ding Wen-Yuan
Department of Orthopedics, Wuxi NO. 9 People's Hospital Affiliated to Soochow University, Wuxi Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Medicine (Baltimore). 2017 Nov;96(45):e8560. doi: 10.1097/MD.0000000000008560.
We aim to perform a meta-analysis on incidence of C5 nerve root palsy (C5 palsy) for patients after cervical surgery.
An extensive search of the literature was performed in PubMed/MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG databases on incidence of C5 palsy from January 2007 to January 2017. Prevalence of C5 palsy related to different surgery methods was calculated and data analysis was conducted with STATA 12.0.
A total of 61 studies containing 721 patients with C5 palsy in total 11,481 patients (6.3%) were included in our study. The incidences after anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), anterior corpectomy combined with discectomy (ACCDF), laminoplasty (LP) and laminectomy and fusion (LF) were 5.5%, 7.5%, 6%, 4.4%, and 12.2%, respectively. Compared with anterior approaches (5%), female patients (4%) and patients with cervical spondylotic myelopathy (CSM) (4.8%), posterior approaches (6.2%), male patients (5.7%) and patients with ossification of posterior longitudinal ligament (OPLL) (8.1%) have a higher prevalence. In ACDF and LP, patients with OPLL (5.5%, 8.1%, respectively) have a higher incidence than those in patients with CSM (4.7%, 3.1%, respectively); however, in LF, patients with CSM and OPLL have similar incidence of C5 palsy (13% vs 13.1%). In most cases, C5 palsy was unilateral (74.5%).
Based on our meta-analysis, posterior approaches, male patients and patients with OPLL have a higher incidence of C5 palsy. In ACDF and LP, patients with OPLL have a higher incidence of C5 palsy, but in LF, patients with CSM and OPLL have similar result.
我们旨在对颈椎手术后患者的C5神经根麻痹（C5麻痹）发生率进行荟萃分析。
在PubMed/MEDLINE、Embase、Cochrane图书馆、CNKI和万方数据库中广泛检索2007年1月至2017年1月期间关于C5麻痹发生率的文献。计算与不同手术方法相关的C5麻痹患病率，并使用STATA 12.0进行数据分析。
我们的研究共纳入61项研究，总计11481例患者中有721例C5麻痹患者（6.3%）。颈椎前路椎间盘切除融合术（ACDF）、颈椎前路椎体次全切除融合术（ACCF）、椎体次全切除联合椎间盘切除术（ACCDF）、椎板成形术（LP）和椎板切除融合术（LF）后的发生率分别为5.5%、7.5%、6%、4.4%和12.2%。与前路手术（5%）、女性患者（4%）和脊髓型颈椎病（CSM）患者（4.8%）相比，后路手术（6.2%）、男性患者（5.7%）和后纵韧带骨化（OPLL）患者（8.1%）的患病率更高。在ACDF和LP中，OPLL患者（分别为5.5%、8.1%）的发生率高于CSM患者（分别为4.7%、3.1%）；然而，在LF中，CSM和OPLL患者的C5麻痹发生率相似（13%对13.1%）。在大多数情况下，C5麻痹为单侧（74.5%）。
基于我们的荟萃分析，后路手术、男性患者和OPLL患者的C5麻痹发生率较高。在ACDF和LP中，OPLL患者的C5麻痹发生率较高，但在LF中，CSM和OPLL患者的结果相似。
