C5-Parese nach Operationen bei zervikaler Myelopathie

Zusammenfassung

Eine der häufigeren Komplikationen bei Operationen der Halswirbelsäule stellt die postoperative Parese des fünften Halsnerven dar (C5-Parese). Die Inzidenz schwankt je nach Ausdehnung des Eingriffs und Art des Zugangs erheblich (0 – 50 %) und wird im Mittel mit 5 – 6 % angegeben. Ursächlich werden demografische Faktoren, lagerungsassoziierte Faktoren, die direkte Reizung des Nervens intraoperativ, die Rückenmarkrotation, anatomische Besonderheiten, das Tethering der Nervenwurzel im Neuroforamen und vieles andere diskutiert. Abschließend ist die Ätiologie aber nicht geklärt und man geht von einem multifaktoriellen Geschehen aus. In dieser Übersichtsarbeit werden Daten aus aktuellen Publikationen sowie Daten aus einer eigenen Kohorte präsentiert. Die Risikofaktoren der einzelnen Zugänge werden erläutert und mögliche prophylaktische Maßnahmen diskutiert.

Abstract

One of the most common complications in cervical spine surgery is postoperative C5 nerve root palsy with an overall incidence of 5 – 6 % with ranges from 0 – 50 %. Causative numerous differing factors have been discussed especially demographic factors, shoulder traction, direct intraoperative nerve root injury, spinal cord rotation, special anatomical characteristics, post decompression nerve root tethering and many others. Unfortunately, the etiology of the postoperative C5 palsy is still not clearly understood for what reason a multifactorial cause is the leading scientific opinion.

This review presents an overview of the current literature and data of our own large cohort. Approach depending risk factors and possible prophylactic procedures are presented and discussed.

Schlüsselwörter

C5 Parese - zervikale Myelopathie - Zugang zur HWS

Keywords

cervical myelopathy - C5 palsy - surgical approach

Publication History

Article published online:
29 October 2020

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