A Case of Posterolateral Cervical Decompression with Fixation for C5 Palsy

Abstract

  Anterior and posterior approaches are commonly used for surgical decompressive procedures of intervertebral foraminal stenosis presenting with cervical radiculopathy. However, extraforaminal stenosis is limited anteriorly by vertebral arteries and posteriorly by facet joint resections. Therefore, surgical access to extraforaminal stenosis in the middle cervical spine is the most difficult.

  We report the case of a 74-year-old man who underwent posterior cervical foraminotomy with fixation for painful C5 paralysis, but C5 paralysis remained. He had residual extraforaminal stenosis and added decompression fusion with a posterolateral approach. Postoperative symptoms completely recovered.

  Posterolateral decompression from the posterior cervical triangle may represent a third approach for cervical radiculopathy, particularly C5 palsy. Anatomical considerations of the neck muscles, facet joints, and C5 nerve root are also reported.