Wee Tze Chao, O'Riordan Jennifer
Changi General Hospital, 2 Simei Street 3, Singapore 529889.
Biomedicine (Taipei). 2018 Sep;8(3):20. doi: 10.1051/bmdcn/2018080320. Epub 2018 Aug 24.
We report on a patient who had neurological deterioration attributed to C5 palsy post C3-C6 posterior decompression and instrumented fusion. A 60-year old man was admitted after a fall from an electric scooter. MRI of the cervical spine confirmed severe cervical spondylosis causing cord compression at C4/5 with associated cord oedema. He underwent posterior cervical decompressive surgery, and he remained neurologically stable post operatively. However, he subsequently developed acute left upper limb weakness limited to the C5 myotome 1 week after surgery whilst undergoing inpatient rehabilitation. A repeat MRI of the cervical spine did not reveal any new changes that may explain his symptoms. He was started on intravenous dexamethasone. C5 palsy after cervical decompressive surgery is not uncommon. There is no specific evidence-based treatment and it carries a generally good prognosis. The aim of this case report is to highlight this complication and raise awareness amongst physicians.
我们报告了一例在C3 - C6后路减压及器械融合术后出现因C5麻痹导致神经功能恶化的患者。一名60岁男性在骑电动滑板车摔倒后入院。颈椎MRI证实严重颈椎病，导致C4/5水平脊髓受压并伴有脊髓水肿。他接受了颈椎后路减压手术，术后神经功能保持稳定。然而，在住院康复期间，术后1周他随后出现局限于C5肌节的急性左上肢无力。颈椎再次MRI检查未发现任何可解释其症状的新变化。他开始接受静脉注射地塞米松治疗。颈椎减压术后C5麻痹并不罕见。目前尚无基于循证医学的特异性治疗方法，其预后总体良好。本病例报告的目的是强调这一并发症并提高医生的认识。
