Abstract: Objective To investigate the incidence of C5 nerve root palsy after multi-segmental cervical decompression through
different approaches. Methods This study was conducted among 375 patients undergoing multi-segmental cervical
decompression in anterior corpectomy and fusion fixation, anterior cervical corpectomy and fusion fixation + posterior
decompression and fusion fixation, posterior cervical laminectomy decompression, fusion and internal fixation, and posterior
laminoplasty and fusion groups. The exclusion criteria included lack of follow-up data, spinal cord injury preventing
preoperative or postoperative motor testing, or surgery not involving the C5 level. The incidence of C5 palsy was determined
and the potential risk factors C5 palsy were analyzed including age, sex, revision surgery, preoperative weakness, diabetes,
smoking, number of levels decompressed, and a history of previous upper extremity surgery. Results Of the 375 patients, 60
patients were excluded and the data of 315 patients were analyzed, including 146 women and 169 men with a mean age of 57.7
years (range 39-72 years). The overall incidence of C5 nerve palsy was 6.03% (19/315) in these patients; in the subgroups
receiving different surgeries, the incidence was 8.62% in the cervical road laminectomy and fusion fixation group, 7.79% in the
anterior cervical corpectomy and fusion fixation + posterior decompression and fusion and internal fixation, 4.68% in the anterior
corpectomy and fusion fixation group, and 3.85% in the posterior laminoplasty and fusion group. No significant difference was
found in the incidences among the subgroups, but men were more likely than women to develop cervical nerve root palsy (8.28%
vs 3.42%, P<0.05). Conclusion The overall incidence of C5 nerve palsy following postoperative cervical spinal decompression
was 6.03% in our cohort. The incidence of C5 nerve palsy did not differ significantly following different cervical decompression
surgeries, but the incidence was the highest in the posterior cervical laminectomy and fusion and internal fixation group.