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Improvement in the results of the simple-foot-tapping test and cross-sectional area of the dural sac in patients with C5 palsy after posterior cervical spine surgery

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Abstract

Introduction

The smaller cross-sectional areas of the dural sacs in patients without C5 palsy after posterior cervical spine surgery may lead to less neurological improvement.

Objectives

The aim of this retrospective study was to clarify the differences in the cross-sectional area of the dural sac in the cervical spine and neurological improvement in patients with and without C5 palsy after posterior cervical spinal surgery.

Methods

We retrospectively evaluated the postoperative cross-sectional areas of the dural sacs and neurological outcomes in patients with and without C5 palsy after posterior cervical spine surgery. We compared the postoperative cross-sectional areas of the dural sac at C4/5 and C5/6 on magnetic resonance images between the C5 palsy group (n = 19) and the no-C5 palsy group (n = 84) after posterior cervical spinal surgery 1 year postoperatively. Performance tests, namely, the 10-s grip-and-release test and the 10-s single-foot-tapping (FT) test, were compared between the two groups.

Results

Postoperative cross-sectional areas of the dural sac at C4/5 and C5/6 (233.3 mm2 and 226.6 mm2, respectively) in the C5 palsy group were significantly larger (P = 0.0036 and P = 0.0039, respectively) than those (195.0 mm2 and 193.8 mm2, respectively) in the no-C5 palsy group. Postoperative gain in the grip-and-release test was similar between the two groups. Postoperative gain in the FT test (4.9 times) in the C5 palsy group was significantly larger (P = 0.0060) than that (1.8 times) in the no-C5 palsy group.

Conclusions

In the C5 palsy group 1 year after posterior cervical spine surgery, the cross-sectional areas of the dural sac were larger, and the 10-s single FT test improved noticeably.

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Funding

No funds were received in support of this work.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Odate Municipal General Hospital, Odate, Akita, Japan

    Kazunari Takeuchi, Toru Yokoyama, Taku Fujita, Tatsuhiro Fukutoku, Kazushige Koyama & Masayuki Ichinohe

  2. Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan

    Kanichiro Wada, Gentaro Kumagai, Sunao Tanaka, Toru Asari, Eiji Sasaki & Yasuyuki Ishibashi

  3. Department of Orthopedic Surgery, Mutsu General Hospital, Mutsu, Aomori, Japan

    Hitoshi Kudo

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  1. Kazunari Takeuchi
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  2. Toru Yokoyama
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  4. Gentaro Kumagai
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  5. Hitoshi Kudo
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  13. Yasuyuki Ishibashi
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Contributions

KT wrote and prepared the manuscript, and all of the authors participated in the study design. All authors have read, reviewed, and approved the article.

Corresponding author

Correspondence to Kazunari Takeuchi.

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The authors declare that they have no conflict of interest.

Ethics approval

This study was approved by the institutional ethics committee of Odate Municipal General Hospital (Approval No. 30-09), and informed consent was obtained from all participants.

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Takeuchi, K., Yokoyama, T., Wada, K. et al. Improvement in the results of the simple-foot-tapping test and cross-sectional area of the dural sac in patients with C5 palsy after posterior cervical spine surgery. Eur J Orthop Surg Traumatol 30, 1401–1409 (2020). https://doi.org/10.1007/s00590-020-02715-1

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  • DOI: https://doi.org/10.1007/s00590-020-02715-1

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