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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >P.127 Preventing C5 palsy after cervical decompression by nerve root untethering and intraforaminal ligament release
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P.127 Preventing C5 palsy after cervical decompression by nerve root untethering and intraforaminal ligament release

机译：P.127通过神经根除术后宫颈减压后防止C5麻痹和血压韧带释放

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Background: Postoperative C5 palsy (C5P) is a common complication after cervical decompression, potentially related to nerve root tethering. To our knowledge, this is the first study to investigate this hypothesis by comparing C5/C6 root translation and tension before and after root untethering by cutting cervical intraforaminal ligaments (IFL). Methods: Six cadaveric dissections were performed. Nerve roots were exposed and translation and tension measured after the roots and spinal-cord were dorsally displaced 5mm before and after IFL cutting. These were also measured during shoulder depression to simulate intraoperative positioning. Clinical feasibility of IFL release was examined by comparing standard and extended foraminotomies to compare resultant root translation. Results: IFL-cutting increased translation at both C5/C6 roots (P=0.001). There was no difference between root levels (P=0.33). IFL-cutting increased translation upon shoulder depression at both C5/C6 roots (P=0.003) with a difference also being found between root levels (P=0.02). An extended cervical foraminotomy was technically feasible which enabled complete IFL release and root untethering, whereas a standard foraminotomy did not. Conclusions: IFL-cutting increases root translation, suggesting they are either protective (preventing peripheral nerve strain from being transmitted to the spinal-cord) or harmful (by tethering intraforaminal nerve roots and potentially contributing to postoperative C5P) depending on the clinical context.
机译：背景：术后C5麻痹（C5P）是宫颈减压后的常见并发症，潜在与神经根系系列相关。为了我们的知识，这是通过在通过切割宫颈血症韧带（IFL）之前和根除根除前后的C5 / C6根转换和张力来研究这一假设的第一研究。方法：进行六种尸体剖粉。暴露神经根部暴露，在根和脊髓帘线后测量的翻译和张力在IF1切割之前和之后偏移5mm。这些也在肩部抑制期间测量以模拟术中定位。通过比较标准和扩展的传染术来检查IFL释放的临床可行性，以比较所得到的根本翻译。结果：C5 / C6根部的IF1切割增加（P = 0.001）。根级别没有区别（p = 0.33）。 IF1切割在C5 / C6根的肩部抑制时增加转换（p = 0.003），并且在根级之间发现差异（p = 0.02）。延长的宫颈传染术在技术上是可行的，它使完全的IFL释放和根除根除，而标准的传染术没有。结论：IFL切割增加根翻译，表明它们是保护性的（防止外周神经菌株传递给脊髓）或有害（通过培养患有血液神经根部并潜在地贡献至术后C5P）。

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