C5 Palsy After C4-C7 ACDF

C5 Palsy After C4-C7 ACDF presented by Daniel Reid, MD, on January 25, 2021. This case presentation is part of the ongoing Fellows Case Conferences hosted by the San Diego Spine Foundation.

[@cheritzawhisenhunt]

March 12 I underwent anterior cervical dissecting me with five disc replacement from C3 to C7 with hip bone and a titanium cage. Pre-surgery I could use my right arm post surgery ended up with C-5 palsy with my right arm. Almost 3 weeks later I can do somewhat of a bicep curl so I just continue on my exercises with PT. I was wondering if there was any other case studies out there that I might be able to look into or be a part of concerning C5 plays. I’m a healthy 54-year-old female very active throughout life. I would appreciate any feedback or comments that might help me along this new journey. Dr. Viet Tran at a Seton Austin Texas is an amazing surgeon and I appreciate him and all his staff for what they have done.

[@BreakerOneNine07]

I had multiple level posterior fusion c3-c6, c3-c7 laminectomies with left side foraminotomies a month ago and since day 2 of recovery, I haven't been able to use either arm, because of bilateral C5 Palsy. I can't do anything by myself and wouldn't wish this on my worst enemy! I also have the pleasure of a lot of extra pain included with my C5 Palsy. I have been in physical therapy for 2 and a half weeks, with no success at all. My surgery was done by one of the top cervical specialist at Duke and I'm not happy with him at all! I was never informed of this even being a possibility of a side effect before surgery and the doctor seems to be brushing it to the side, acting like it's not a big deal. Well, it's a big deal when literally both of your arms are completely useless!

[@brianhiggins9601]

How is your outcome ? Have you regained arm function?

[@BreakerOneNine07]

@@brianhiggins9601 I gained 40% use back. Most likely going to have to get another surgery done. My normal neurosurgeon, who did my lumbar surgeries, is going to do it. The only reason he didn't do it to begin with, is he's becoming a lumbar specialist. He started doing only lumbar surgeries and refers out his thoracic and cervical stuff. He's going to make an exception for me thankfully! If you ever need lumbar surgery, look up Dr. Oren Gottfried at Duke! He's one of the best in the country!

[@stevenfox5241]

I am praying for you, I am so sorry to hear of this. I had an ACDF - C4 to C7 on 10-24-23 and I have severe unilateral Right-sided C5 Palsy which began on 12-31-23...so there was a 2 month and 7 day delay between my surgery and the onset of my C5 Palsy. Luckily my left side is normal in terms of motor loss, but I am experiencing a ton of nerve pain - left cervical radiculopathy on my left side. My right side with the C5 Palsy - I have very very weak Deltoid strength and very very weak Biceps strength - I cannot even curl a 4 ounce can of soup ! I literally cannot even curl a 4 ounce can of soup, that is how weak my right biceps are. I am seriously considering an Oberlin nerve transfer of my ulnar nerve to my musculotaneous nerve if things do not improve significantly by 4 months post incident. Breakeronenine, I am so sorry to hear of your story. I am praying for you to get better.

[@BreakerOneNine07]

@@brianhiggins9601 8 months post op and I have only gained 40% use in both arms. Most likely gonna have to get another surgery to "hopefully" get more use back. I also can't look up but maybe 30 degrees. I completely dropped the surgeon who did my surgery and have a new surgeon that is going to attempt to somewhat fix this mess.

[@avfan967]

Fascinating discussion. Thanks for posting!

[@steveng8251]

I recently had an ACDF at C5/6 and thankfully do not have C5 palsy. I still have tingle in the hands and a little up the arms also the weird warm arm and almost feeling like I am going to faint with a hard cough and associated diaphragmatic spasms, ( which I think are due to a prior muscle strain from coughing),. My tingle in my hands post surgery went from the feeling of cold and numb to numb and being warmed under warm water, not burning but buzzing. I had headaches where I have muscular adhesions and T2/3 muscle spasms for two weeks post surgical. Overall I feel as though I have some more energy and cognitive abilities as in less brain fog post surgery. I am hopeful that normalcy will return to my hands and a decrease in the high alert signals that my body feels like it is in.

[@AG-zn8mn]

How's your progress?

[@mnr2inh]

I would like take 2nd option for my cirvical spondilisis

[@Raj-ul9my]

Disc replacement is the solution, not cage and fusion,

[@googleappuser4146]

Maybe, if the surgeon is "extremely meticulous about the decompression, alignment etc" according to Dr Riew....Ive been in torturous pain since 2 level simplify disc "fastectomy" by a surgeon who assured me he's done a couple ADR and they weren't that tough. Dr Riew has said a lot about my dermatome referral pain 50hrs of SSF cervical lectures never mentioned and none of the 5 surgeons I saw knew was c5-7 nerve root dermatome. Riew details how studies about adjacent segment disease and range of motion aren't even half what the most cited studies say.... The ADR data just isn't as reliable and not nearly as long term. Definitely contraindicated for spondylosis and myelopathy he says in one lecture. The only place I've heard that. My surgeon said to me he didnt remove bonespurs I asked him 4 times if he'd remove, in addition to not aligning the discs well

[@butters2249]

@@googleappuser4146I can relate to your story as well. How are you doing now?