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Review Question - QID 978

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QID 978 (Type "978" in App Search)
Postoperative radiculopathy is a known complication of posterior cervical decompression for myelopathy. One potential mechanism of nerve root injury is thought to be tethering of the nerve root with dorsal migration of the spinal cord. What is the most common radicular pattern seen with this condition?

Motor-dominant radiculopathy with weakness of the deltoid

64%

1843/2879

Sensory-dominant radiculopathy with pain in the lateral shoulder

20%

562/2879

Motor-dominant radiculopathy with weakness of the wrist extensors

7%

207/2879

Sensory-dominant radiculopathy with pain in the lateral forearm

6%

177/2879

Motor-dominant radiculopathy with weakness of the triceps

3%

77/2879

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The study by Dai et al retrospectively reviewed 287 consecutive patients with cervical compression myelopathy who had been treated by multilevel cervical laminectomy and identified 37 (12.9%) with postoperative radiculopathy. The diagnosis was either cervical spondylosis (25 patients) or ossification of the posterior longitudinal ligament (12 patients). Radiculopathy was observed from four hours to six days after surgery. The most frequent pattern of paralysis was involvement of the C5 roots of the motor-dominant type. They argue, in support of prior studies by Tsuzuki et al, that postoperative radiculopathy is caused by a tethering injury to the root caused by of expansion and dorsal migration of the spinal cord rather than a technical problem.

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