Prognostic Factors for Postsurgical Recovery of Deltoid Palsy due to Cervical Disc Herniations
Retrospective multicenter study. We aimed to investigate prognostic factors affecting postsurgical recovery of deltoid palsy due to cervical disc herniation (CDH). Little information is available about prognostic factors affecting postsurgical recovery of deltoid palsy due to CDH. Sixty-one patients...
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| Published in | Asian spine journal Vol. 9; no. 5; pp. 694 - 698 |
|---|---|
| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Korea (South)
Korean Society of Spine Surgery
01.10.2015
Korean Spine Society 대한척추외과학회 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1976-1902 1976-7846 |
| DOI | 10.4184/asj.2015.9.5.694 |
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| Abstract | Retrospective multicenter study.
We aimed to investigate prognostic factors affecting postsurgical recovery of deltoid palsy due to cervical disc herniation (CDH).
Little information is available about prognostic factors affecting postsurgical recovery of deltoid palsy due to CDH.
Sixty-one patients with CDH causing deltoid palsy (less than grade 3) were included in this study: 35 soft discs and 26 hard discs. Average duration of preoperative deltoid palsy was 11.9 weeks. Thirty-two patients underwent single-level surgery, 22 two-level, four three-level, and three four-level. Patients with accompanying myelopathy, shoulder diseases, or peripheral neuropathy were excluded from the study.
Deltoid palsy (2.4 grades vs. 4.5 grades, p<0.001) and radiculopathy (6.4 points vs. 2.1 points, p<0.001) significantly improved after surgery. Thirty-six of 61 patients (59%) achieved full recovery (grade 5) of deltoid palsy, with an average time of 8.4 weeks. Longer duration of preoperative deltoid palsy and more severe radiculopathy negatively affected the degree of improvement in deltoid palsy. Age, gender, number of surgery level, and disc type did not affect the degree of improvement of deltoid palsy. Contrary to our expectations, severity of preoperative deltoid palsy did not affect the degree of improvement. Due to the shorter duration of preoperative deltoid palsy, in the context of rapid referral, early surgical decompression resulted in significant recovery of more severe grades (grade 0 or 1) of deltoid palsy compared to grade 2 or 3 deltoid palsy.
Early surgical decompression significantly improved deltoid palsy caused by CDH, irrespective of age, gender, number of surgery level, and disc type. However, longer duration of deltoid palsy and more severe intensity of preoperative radiating pain were associated with less improvement of deltoid palsy postoperatively. |
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| AbstractList | Study DesignRetrospective multicenter study.PurposeWe aimed to investigate prognostic factors affecting postsurgical recovery of deltoid palsy due to cervical disc herniation (CDH).Overview of LiteratureLittle information is available about prognostic factors affecting postsurgical recovery of deltoid palsy due to CDH.MethodsSixty-one patients with CDH causing deltoid palsy (less than grade 3) were included in this study: 35 soft discs and 26 hard discs. Average duration of preoperative deltoid palsy was 11.9 weeks. Thirty-two patients underwent single-level surgery, 22 two-level, four three-level, and three four-level. Patients with accompanying myelopathy, shoulder diseases, or peripheral neuropathy were excluded from the study.ResultsDeltoid palsy (2.4 grades vs. 4.5 grades, p<0.001) and radiculopathy (6.4 points vs. 2.1 points, p<0.001) significantly improved after surgery. Thirty-six of 61 patients (59%) achieved full recovery (grade 5) of deltoid palsy, with an average time of 8.4 weeks. Longer duration of preoperative deltoid palsy and more severe radiculopathy negatively affected the degree of improvement in deltoid palsy. Age, gender, number of surgery level, and disc type did not affect the degree of improvement of deltoid palsy. Contrary to our expectations, severity of preoperative deltoid palsy did not affect the degree of improvement. Due to the shorter duration of preoperative deltoid palsy, in the context of rapid referral, early surgical decompression resulted in significant recovery of more severe grades (grade 0 or 1) of deltoid palsy compared to grade 2 or 3 deltoid palsy.ConclusionsEarly surgical decompression significantly improved deltoid palsy caused by CDH, irrespective of age, gender, number of surgery level, and disc type. However, longer duration of deltoid palsy and more severe intensity of preoperative radiating pain were associated with less improvement of deltoid palsy postoperatively. Retrospective multicenter study. We aimed to investigate prognostic factors affecting postsurgical recovery of deltoid palsy due to cervical disc herniation (CDH). Little information is available about prognostic factors affecting postsurgical recovery of deltoid palsy due to CDH. Sixty-one patients with CDH causing deltoid palsy (less than grade 3) were included in this study: 35 soft discs and 26 hard discs. Average duration of preoperative deltoid palsy was 11.9 weeks. Thirty-two patients underwent single-level surgery, 22 two-level, four three-level, and three four-level. Patients with accompanying myelopathy, shoulder diseases, or peripheral neuropathy were excluded from the study. Deltoid palsy (2.4 grades vs. 4.5 grades, p<0.001) and radiculopathy (6.4 points vs. 2.1 points, p<0.001) significantly improved after surgery. Thirty-six of 61 patients (59%) achieved full recovery (grade 5) of deltoid palsy, with an average time of 8.4 weeks. Longer duration of preoperative deltoid palsy and more severe radiculopathy negatively affected the degree of improvement in deltoid palsy. Age, gender, number of surgery level, and disc type did not affect the degree of improvement of deltoid palsy. Contrary to our expectations, severity of preoperative deltoid palsy did not affect the degree of improvement. Due to the shorter duration of preoperative deltoid palsy, in the context of rapid referral, early surgical decompression resulted in significant recovery of more severe grades (grade 0 or 1) of deltoid palsy compared to grade 2 or 3 deltoid palsy. Early surgical decompression significantly improved deltoid palsy caused by CDH, irrespective of age, gender, number of surgery level, and disc type. However, longer duration of deltoid palsy and more severe intensity of preoperative radiating pain were associated with less improvement of deltoid palsy postoperatively. Retrospective multicenter study.STUDY DESIGNRetrospective multicenter study.We aimed to investigate prognostic factors affecting postsurgical recovery of deltoid palsy due to cervical disc herniation (CDH).PURPOSEWe aimed to investigate prognostic factors affecting postsurgical recovery of deltoid palsy due to cervical disc herniation (CDH).Little information is available about prognostic factors affecting postsurgical recovery of deltoid palsy due to CDH.OVERVIEW OF LITERATURELittle information is available about prognostic factors affecting postsurgical recovery of deltoid palsy due to CDH.Sixty-one patients with CDH causing deltoid palsy (less than grade 3) were included in this study: 35 soft discs and 26 hard discs. Average duration of preoperative deltoid palsy was 11.9 weeks. Thirty-two patients underwent single-level surgery, 22 two-level, four three-level, and three four-level. Patients with accompanying myelopathy, shoulder diseases, or peripheral neuropathy were excluded from the study.METHODSSixty-one patients with CDH causing deltoid palsy (less than grade 3) were included in this study: 35 soft discs and 26 hard discs. Average duration of preoperative deltoid palsy was 11.9 weeks. Thirty-two patients underwent single-level surgery, 22 two-level, four three-level, and three four-level. Patients with accompanying myelopathy, shoulder diseases, or peripheral neuropathy were excluded from the study.Deltoid palsy (2.4 grades vs. 4.5 grades, p<0.001) and radiculopathy (6.4 points vs. 2.1 points, p<0.001) significantly improved after surgery. Thirty-six of 61 patients (59%) achieved full recovery (grade 5) of deltoid palsy, with an average time of 8.4 weeks. Longer duration of preoperative deltoid palsy and more severe radiculopathy negatively affected the degree of improvement in deltoid palsy. Age, gender, number of surgery level, and disc type did not affect the degree of improvement of deltoid palsy. Contrary to our expectations, severity of preoperative deltoid palsy did not affect the degree of improvement. Due to the shorter duration of preoperative deltoid palsy, in the context of rapid referral, early surgical decompression resulted in significant recovery of more severe grades (grade 0 or 1) of deltoid palsy compared to grade 2 or 3 deltoid palsy.RESULTSDeltoid palsy (2.4 grades vs. 4.5 grades, p<0.001) and radiculopathy (6.4 points vs. 2.1 points, p<0.001) significantly improved after surgery. Thirty-six of 61 patients (59%) achieved full recovery (grade 5) of deltoid palsy, with an average time of 8.4 weeks. Longer duration of preoperative deltoid palsy and more severe radiculopathy negatively affected the degree of improvement in deltoid palsy. Age, gender, number of surgery level, and disc type did not affect the degree of improvement of deltoid palsy. Contrary to our expectations, severity of preoperative deltoid palsy did not affect the degree of improvement. Due to the shorter duration of preoperative deltoid palsy, in the context of rapid referral, early surgical decompression resulted in significant recovery of more severe grades (grade 0 or 1) of deltoid palsy compared to grade 2 or 3 deltoid palsy.Early surgical decompression significantly improved deltoid palsy caused by CDH, irrespective of age, gender, number of surgery level, and disc type. However, longer duration of deltoid palsy and more severe intensity of preoperative radiating pain were associated with less improvement of deltoid palsy postoperatively.CONCLUSIONSEarly surgical decompression significantly improved deltoid palsy caused by CDH, irrespective of age, gender, number of surgery level, and disc type. However, longer duration of deltoid palsy and more severe intensity of preoperative radiating pain were associated with less improvement of deltoid palsy postoperatively. Study Design Retrospective multicenter study. Purpose We aimed to investigate prognostic factors affecting postsurgical recovery of deltoid palsy due to cervical disc herniation (CDH). Overview of Literature Little information is available about prognostic factors affecting postsurgical recovery of deltoid palsy due to CDH. Methods Sixty-one patients with CDH causing deltoid palsy (less than grade 3) were included in this study: 35 soft discs and 26 hard discs. Average duration of preoperative deltoid palsy was 11.9 weeks. Thirty-two patients underwent single-level surgery, 22 two-level, four three-level, and three four-level. Patients with accompanying myelopathy, shoulder diseases, or peripheral neuropathy were excluded from the study. Results Deltoid palsy (2.4 grades vs. 4.5 grades, p<0.001) and radiculopathy (6.4 points vs. 2.1 points, p<0.001) significantly improved after surgery. Thirty-six of 61 patients (59%) achieved full recovery (grade 5) of deltoid palsy, with an average time of 8.4 weeks. Longer duration of preoperative deltoid palsy and more severe radiculopathy negatively affected the degree of improvement in deltoid palsy. Age, gender, number of surgery level, and disc type did not affect the degree of improvement of deltoid palsy. Contrary to our expectations, severity of preoperative deltoid palsy did not affect the degree of improvement. Due to the shorter duration of preoperative deltoid palsy, in the context of rapid referral, early surgical decompression resulted in significant recovery of more severe grades (grade 0 or 1) of deltoid palsy compared to grade 2 or 3 deltoid palsy. Conclusions Early surgical decompression significantly improved deltoid palsy caused by CDH, irrespective of age, gender, number of surgery level, and disc type. However, longer duration of deltoid palsy and more severe intensity of preoperative radiating pain were associated with less improvement of deltoid palsy postoperatively. Study Design: Retrospective multicenter study. Purpose: We aimed to investigate prognostic factors affecting postsurgical recovery of deltoid palsy due to cervical disc herniation (CDH). Overview of Literature: Little information is available about prognostic factors affecting postsurgical recovery of deltoid palsy due to CDH. Methods: Sixty-one patients with CDH causing deltoid palsy (less than grade 3) were included in this study: 35 soft discs and 26 hard discs. Average duration of preoperative deltoid palsy was 11.9 weeks. Thirty-two patients underwent single-level surgery, 22 two-level, four three-level, and three four-level. Patients with accompanying myelopathy, shoulder diseases, or peripheral neuropathy were excluded from the study. Results: Deltoid palsy (2.4 grades vs. 4.5 grades, p <0.001) and radiculopathy (6.4 points vs. 2.1 points, p <0.001) significantly improved after surgery. Thirty-six of 61 patients (59%) achieved full recovery (grade 5) of deltoid palsy, with an average time of 8.4 weeks. Longer duration of preoperative deltoid palsy and more severe radiculopathy negatively affected the degree of improvement in deltoid palsy. Age, gender, number of surgery level, and disc type did not affect the degree of improvement of deltoid palsy. Contrary to our expectations, severity of preoperative deltoid palsy did not affect the degree of improvement. Due to the shorter duration of preoperative deltoid palsy, in the context of rapid referral, early surgical decompression resulted in significant recovery of more severe grades (grade 0 or 1) of deltoid palsy compared to grade 2 or 3 deltoid palsy. Conclusions: Early surgical decompression significantly improved deltoid palsy caused by CDH, irrespective of age, gender, number of surgery level, and disc type. However, longer duration of deltoid palsy and more severe intensity of preoperative radiating pain were associated with less improvement of deltoid palsy postoperatively. KCI Citation Count: 0 |
| Author | Lee, Jung Sub Song, Kyung-Jin Lee, Sang-Hun Uh, Jae-Hyung Chang, Han Kim, Jin-Hyok Lee, Jae Min Chung, Jae-Yoon Kim, Young-Tae Yang, Jae Jun Park, Jong-Beom Song, Kwang-Sup Hong, Chang-Hwa |
| AuthorAffiliation | 2 Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea 1 Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea |
| AuthorAffiliation_xml | – name: 2 Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea – name: 1 Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea |
| Author_xml | – sequence: 1 givenname: Jae-Yoon surname: Chung fullname: Chung, Jae-Yoon organization: Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea – sequence: 2 givenname: Jong-Beom surname: Park fullname: Park, Jong-Beom organization: Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea., Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea – sequence: 3 givenname: Han surname: Chang fullname: Chang, Han organization: Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea – sequence: 4 givenname: Kyung-Jin surname: Song fullname: Song, Kyung-Jin organization: Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea – sequence: 5 givenname: Jin-Hyok surname: Kim fullname: Kim, Jin-Hyok organization: Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea – sequence: 6 givenname: Chang-Hwa surname: Hong fullname: Hong, Chang-Hwa organization: Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea – sequence: 7 givenname: Jung Sub surname: Lee fullname: Lee, Jung Sub organization: Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea – sequence: 8 givenname: Sang-Hun surname: Lee fullname: Lee, Sang-Hun organization: Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea – sequence: 9 givenname: Kwang-Sup surname: Song fullname: Song, Kwang-Sup organization: Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea – sequence: 10 givenname: Jae Jun surname: Yang fullname: Yang, Jae Jun organization: Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea – sequence: 11 givenname: Jae-Hyung surname: Uh fullname: Uh, Jae-Hyung organization: Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea – sequence: 12 givenname: Young-Tae surname: Kim fullname: Kim, Young-Tae organization: Cervical Spine Study Group, Korean Society of Spine Surgery, Seoul, Korea – sequence: 13 givenname: Jae Min surname: Lee fullname: Lee, Jae Min organization: Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea |
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| Keywords | Postsurgical recovery Deltoid palsy Cervical disc herniation Prognostic factors |
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| References_xml | – volume: 37 start-page: E109 year: 2012 ident: 10.4184/asj.2015.9.5.694_ref2 publication-title: Spine (Phila Pa 1976) doi: 10.1097/BRS.0b013e318221b5af – volume: 224 start-page: 110 year: 1989 ident: 10.4184/asj.2015.9.5.694_ref9 publication-title: Anat Rec doi: 10.1002/ar.1092240114 – volume: 12 start-page: 964 year: 1987 ident: 10.4184/asj.2015.9.5.694_ref8 publication-title: Spine (Phila Pa 1976) doi: 10.1097/00007632-198712000-00002 – volume: 7 start-page: 265 year: 2011 ident: 10.4184/asj.2015.9.5.694_ref1 publication-title: HSS J doi: 10.1007/s11420-011-9218-z – volume: 22 start-page: 179 year: 2011 ident: 10.4184/asj.2015.9.5.694_ref3 publication-title: Phys Med Rehabil Clin N Am doi: 10.1016/j.pmr.2010.12.001 – start-page: 319 volume-title: The adult spine: principles and practice year: 1997 ident: 10.4184/asj.2015.9.5.694_ref6 – volume: 19 start-page: 2501 year: 1994 ident: 10.4184/asj.2015.9.5.694_ref11 publication-title: Spine (Phila Pa 1976) doi: 10.1097/00007632-199411001-00002 – volume: 12 start-page: 517 year: 2003 ident: 10.4184/asj.2015.9.5.694_ref5 publication-title: Eur Spine J doi: 10.1007/s00586-003-0541-z – volume: 34 start-page: 895 year: 1994 ident: 10.4184/asj.2015.9.5.694_ref7 publication-title: Neurosurgery doi: 10.1227/00006123-199405000-00017 – volume: 17 start-page: S338 issue: Suppl 2 year: 2008 ident: 10.4184/asj.2015.9.5.694_ref10 publication-title: Eur Spine J doi: 10.1007/s00586-008-0670-5 – volume: 24 start-page: 2 year: 2012 ident: 10.4184/asj.2015.9.5.694_ref4 publication-title: Semin Spine Surg doi: 10.1053/j.semss.2011.11.002 – reference: 3441822 - Spine (Phila Pa 1976). 1987 Dec;12(10):964-8 – reference: 21292153 - Phys Med Rehabil Clin N Am. 2011 Feb;22(1):179-91 – reference: 23024624 - HSS J. 2011 Oct;7(3):265-72 – reference: 12734743 - Eur Spine J. 2003 Oct;12 (5):517-21 – reference: 18425539 - Eur Spine J. 2008 Sep;17 Suppl 2:S338-41 – reference: 7855672 - Spine (Phila Pa 1976). 1994 Nov 15;19(22):2501-4 – reference: 2729613 - Anat Rec. 1989 May;224(1):110-6 – reference: 21587105 - Spine (Phila Pa 1976). 2012 Jan 15;37(2):E109-18 – reference: 8052389 - Neurosurgery. 1994 May;34(5):895-90; discussion 901-2 |
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| SubjectTerms | Central nervous system diseases Cervical disc herniation Clinical Study Decompression Deltoid palsy Gender Pain Paralysis Patients Peripheral neuropathy Postsurgical recovery Prognostic factors Spinal cord Surgery Surgical outcomes 정형외과학 |
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| Title | Prognostic Factors for Postsurgical Recovery of Deltoid Palsy due to Cervical Disc Herniations |
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