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<p>This prospective multicenter study examined the incidence, risk factors, and recovery course of C5 palsy after surgery for cervical ossification of the posterior longitudinal ligament in 482 patients treated at 28 institutions between 2015 and 2017. C5 palsy was defined as a postoperative decline of at least one grade in deltoid MMT strength. Overall, 6.0% of patients developed C5 palsy, with notable variation by surgical procedure: 4.0% after anterior decompression and fusion, 4.6% after laminoplasty, and 11.8% after posterior decompression and fusion. Nearly half of the affected patients developed symptoms on the day of surgery, and deltoid strength dropped from a mean of 4.7 preoperatively to 2.3 at onset. Over the following two years, 81% of patients regained their preoperative motor function. Better outcomes were observed in younger individuals and in those without concurrent biceps brachii weakness, whereas older patients and those with multimuscle involvement showed less favorable recovery. These findings clarify the expected clinical course of C5 palsy after OPLL surgery and highlight patient factors that may help guide prognosis and perioperative counseling.</p>

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Incidence and prognostic factors of postoperative C5 palsy after cervical OPLL surgery: a nationwide prospective multicenter study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月31日

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  • Satoru Egawa,
  • Takashi Hirai,
  • Kenichiro Sakai,
  • Kazuo Kusano,
  • Shunji Tsutsui,
  • Yu Matsukura,
  • Kentaro Yamada,
  • Hiroaki Onuma,
  • Kanichiro Wada,
  • Keiichi Katsumi,
  • Masao Koda,
  • Atsushi Kimura,
  • Takeo Furuya,
  • Satoshi Maki,
  • Norihiro Nishida,
  • Yukitaka Nagamoto,
  • Yasushi Oshima,
  • Kei Ando,
  • Hiroaki Nakashima,
  • Tsutomu Endo,
  • Kanji Mori,
  • Hideaki Nakajima,
  • Kazuma Murata,
  • Masayuki Miyagi,
  • Takashi Kaito,
  • Kei Yamada,
  • Tomohiro Banno,
  • Satoshi Kato,
  • Tetsuro Ohba,
  • Masahiko Takahata,
  • Hiroshi Moridaira,
  • Shunsuke Fujibayashi,
  • Hiroyuki Katoh,
  • Haruo Kanno,
  • Narihito Nagoshi,
  • Hiroshi Taneichi,
  • Shiro Imagama,
  • Yoshiharu Kawaguchi,
  • Katsushi Takeshita,
  • Masaya Nakamura,
  • Morio Matsumoto,
  • Masashi Yamazaki,
  • Toshitaka Yoshii

摘要

This prospective multicenter study examined the incidence, risk factors, and recovery course of C5 palsy after surgery for cervical ossification of the posterior longitudinal ligament in 482 patients treated at 28 institutions between 2015 and 2017. C5 palsy was defined as a postoperative decline of at least one grade in deltoid MMT strength. Overall, 6.0% of patients developed C5 palsy, with notable variation by surgical procedure: 4.0% after anterior decompression and fusion, 4.6% after laminoplasty, and 11.8% after posterior decompression and fusion. Nearly half of the affected patients developed symptoms on the day of surgery, and deltoid strength dropped from a mean of 4.7 preoperatively to 2.3 at onset. Over the following two years, 81% of patients regained their preoperative motor function. Better outcomes were observed in younger individuals and in those without concurrent biceps brachii weakness, whereas older patients and those with multimuscle involvement showed less favorable recovery. These findings clarify the expected clinical course of C5 palsy after OPLL surgery and highlight patient factors that may help guide prognosis and perioperative counseling.