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Mechanisms of Postoperative C5 Paralysis in Cervical Myelopathy : An Investigation Based on Nerve Root Distribution to the Deltoid and Biceps Brachii Muscles Kazuo Kaneko 1 , Toshihiko Taguchi 1 , Shinya Kawai 1 1Department of Orthopaedic Surgery, Yamaguchi University School of Medicine Keyword: cervical myelopathy , 頚髄症 , cervical nerve root , 頚部神経根 pp.383-387
Published Date 2003/4/1
DOI https://doi.org/10.11477/mf.1408100672
  • Abstract
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 To investigate the mechanism of shoulder girdle weakness after laminoplasty, the distribution of nerve roots to the deltoid and biceps brachii muscle was examined in patients with cervical compressive myelopathy. Compound muscle action potentials (CMAPs) following cervical nerve root stimulation were examined, and the intervertebral levels with symptomatic spinal cord compression were determined on the basis of evoked spinal cord potentials (ESCPs). The results showed that the deltoid and biceps muscles of patients with C4-5myelopathy were predominantly innervated by the C5 root.

 In another series, a total of 56 patients who underwent laminoplasty for compressive cervical myelopathy were reviewed. Four of them were identified as having motor-dominant C5 paralysis, and the ESCPs findings indicated that the C4-5 intervertebral level was symptomatic in all four patients (C4-5 in one patient, both C4-5 and C5-6 in 3 patients). In C4-5myelopathy a spinal cord lesion is present at C6 spinal cord, and since there is a strong possibility that the abductor muscles of the shoulder, including the deltoid, are predominantly governed by C5 nerve root, severe clinical manifestations are expected when C5 radiculopathy develops in this situation, and our hypothesis presumably represents one of pathogenetic mechanisms of C5 paralysis after surgery on the cervical spine.


Copyright © 2003, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1286 印刷版ISSN 0557-0433 医学書院

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