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Medicine Nov 2017We aim to perform a meta-analysis on incidence of C5 nerve root palsy (C5 palsy) for patients after cervical surgery. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
We aim to perform a meta-analysis on incidence of C5 nerve root palsy (C5 palsy) for patients after cervical surgery.
METHODS
An extensive search of the literature was performed in PubMed/MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG databases on incidence of C5 palsy from January 2007 to January 2017. Prevalence of C5 palsy related to different surgery methods was calculated and data analysis was conducted with STATA 12.0.
RESULTS
A total of 61 studies containing 721 patients with C5 palsy in total 11,481 patients (6.3%) were included in our study. The incidences after anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), anterior corpectomy combined with discectomy (ACCDF), laminoplasty (LP) and laminectomy and fusion (LF) were 5.5%, 7.5%, 6%, 4.4%, and 12.2%, respectively. Compared with anterior approaches (5%), female patients (4%) and patients with cervical spondylotic myelopathy (CSM) (4.8%), posterior approaches (6.2%), male patients (5.7%) and patients with ossification of posterior longitudinal ligament (OPLL) (8.1%) have a higher prevalence. In ACDF and LP, patients with OPLL (5.5%, 8.1%, respectively) have a higher incidence than those in patients with CSM (4.7%, 3.1%, respectively); however, in LF, patients with CSM and OPLL have similar incidence of C5 palsy (13% vs 13.1%). In most cases, C5 palsy was unilateral (74.5%).
CONCLUSIONS
Based on our meta-analysis, posterior approaches, male patients and patients with OPLL have a higher incidence of C5 palsy. In ACDF and LP, patients with OPLL have a higher incidence of C5 palsy, but in LF, patients with CSM and OPLL have similar result.
Topics: Adult; Cervical Vertebrae; Female; Humans; Incidence; Male; Middle Aged; Orthopedic Procedures; Paralysis; Postoperative Complications; Spinal Diseases; Spinal Nerve Roots
PubMed: 29137073
DOI: 10.1097/MD.0000000000008560 -
Indian Journal of Ophthalmology Aug 2022To describe the etiology, clinical profile, duration of lagophthalmos cases and thereby, framing a decision for the management based on the severity of Exposure...
PURPOSE
To describe the etiology, clinical profile, duration of lagophthalmos cases and thereby, framing a decision for the management based on the severity of Exposure keratitis (EK), Facial palsy (FP) with each etiology and to describe the outcome of the management options.
METHODS
The method was a prospective review of 120 lagophthalmos cases treated at a single tertiary center from January 2018 to January 2019. The main outcome measures were analysing the association between age, etiology, duration and management of lagophthalmos.
RESULTS
Of the 120 patients studied, paralytic etiology was noted in 86 and eyelid etiology in 34 patients. The percentage of various lagophthalmos etiology documented were Bell's palsy (35.83%), lagophthalmos in ICU patients (15%), traumatic facial palsy(FP) (10.80%), stroke associated FP (6.67%), infection associated FP (6.67%), iatrogenic FP, cicatricial lagophthalmos (5%), lagophthalmos post eyelid surgeries (5%), neoplastic FP(3.33%), congenital FP (1.67%), proptosis induced lagophthalmos (1.67%), floppy eyelid syndrome induced lagophthalmos (0.83%) and lid coloboma associated lagophthalmos (0.83%). A statistically significant correlation was noted between exposure keratitis and age, with an increased prevalence age advances. The management showed significant variation with individual etiology, with some etiologies unquestionably requiring surgical management. Surgical management is crucial as the duration of lagophthalmos increases more than 6 weeks, EK involving pupillary axis and poor FP recovery.
CONCLUSION
This study concludes that the conservative management was sufficient in all cases when the duration is less than 1 week, Exposure keratitis not involving the pupillary axis (EK< Grade II) and FP with good functional recovery ( FP < Grade III). The predominant causes being Bell's palsy, lagophthalmos in ICU patients and vascular FP. Whereas, cases with poor functional recovery of facial palsy(FP) and permanent eyelid deformation require definitive surgical management like Traumatic FP & cicatricial lagophthalmos.
Topics: Bell Palsy; Eyelid Diseases; Facial Paralysis; Humans; Keratoconjunctivitis; Prospective Studies
PubMed: 35918976
DOI: 10.4103/ijo.IJO_3017_21 -
Science (New York, N.Y.) Apr 2023Neuroprosthetic technologies can control blood pressure and restore walking.
Neuroprosthetic technologies can control blood pressure and restore walking.
Topics: Humans; Paralysis; Walking; Blood Pressure; Neural Prostheses; Spinal Cord Injuries
PubMed: 37023195
DOI: 10.1126/science.adg7669 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Mar 2022To review the definition and possible etiologies for C palsy. (Review)
Review
OBJECTIVE
To review the definition and possible etiologies for C palsy.
METHODS
The literature on C palsy at home and abroad in recent years was extensively reviewed, and the possible etiologies were analyzed based on clinical practice experience.
RESULTS
There are two main theories (nerve root tether and spinal cord injury) accounting for the occurrence of C palsy, but both have certain limitations. The former can not explain the occurrence of C palsy after anterior cervical spine surgery, and the latter can not explain that the clinical symptoms of C palsy is often the motor dysfunction of the upper limb muscles. Based on the previous reports, combining our clinical experience and research, we propose that the occurrence of C palsy is mainly due to the instrumental injury of anterior horn of cervical spinal cord during anterior cervical decompression. In addition, the C palsy following surgery via posterior approach may be related to the nerve root tether caused by the spinal cord drift after decompression.
CONCLUSION
In view of the main cause of C palsy after cervical decompression, it is recommended to reduce the compression of the spinal cord by surgical instruments to reduce the risk of this complication.
Topics: Cervical Vertebrae; Decompression, Surgical; Humans; Neck; Paralysis
PubMed: 35293181
DOI: 10.7507/1002-1892.202111072 -
British Medical Journal May 1956
Topics: Bell Palsy; Face; Facial Paralysis; Paralysis
PubMed: 13316077
DOI: 10.1136/bmj.1.4975.1087 -
The Journal of Bone and Joint Surgery.... Mar 2010We have reviewed 1858 patients who had undergone a cervical laminoplasty and identified 43 (2.3%) who had developed a C5 palsy with a MMT (MRC) grade of 0 to 2 in the... (Review)
Review
We have reviewed 1858 patients who had undergone a cervical laminoplasty and identified 43 (2.3%) who had developed a C5 palsy with a MMT (MRC) grade of 0 to 2 in the deltoid, with or without involvement of the biceps, but with no loss of muscular strength in any other muscles. The clinical features and radiological findings of patients with (group P; 43 patients) and without (group C; 100 patients) C5 palsy were compared. CT scanning of group P revealed a significant narrowing of the intervertebral foramen of C5 (p < 0.005) and a larger superior articular process (p < 0.05). On MRI, the posterior shift of the spinal cord at C4-5 was significantly greater in group P, than in group C (p < 0.01). This study is the first to correlate impairment of the C5 nerve root with a C5 palsy. It may be that early foraminotomy in susceptible individuals and the avoidance of tethering of the cord by excessive laminoplasty may prevent a post-operative palsy of the C5 nerve root.
Topics: Adult; Aged; Aged, 80 and over; Brachial Plexus Neuropathies; Cervical Vertebrae; Female; Humans; Laminectomy; Magnetic Resonance Imaging; Male; Middle Aged; Movement Disorders; Paralysis; Severity of Illness Index; Spinal Cord Compression; Tomography, X-Ray Computed
PubMed: 20190311
DOI: 10.1302/0301-620X.92B3.22786 -
Hand (New York, N.Y.) Nov 2018Isolated long thoracic nerve palsy results in scapular winging and destabilization. In this study, we review the surgical management of isolated long thoracic nerve...
BACKGROUND
Isolated long thoracic nerve palsy results in scapular winging and destabilization. In this study, we review the surgical management of isolated long thoracic nerve palsy and suggest a surgical technique and treatment algorithm to simplify management.
METHODS
In total, 19 patients who required surgery for an isolated long thoracic nerve palsy were reviewed retrospectively. Preoperative demographics, electromyography (EMG), and physical examinations were reviewed. Intraoperative nerve stimulation, surgical decision making, and postoperative outcomes were reviewed.
RESULTS
In total, 19 patients with an average age of 32 were included in the study. All patients had an isolated long thoracic nerve palsy caused by either an injury (58%), Parsonage-Turner syndrome (32%), or shoulder surgery (10%); 18 patients (95%) underwent preoperative EMG; 10 with evidence of denervation (56%); and 13 patients had motor unit potentials in the serratus anterior (72%). The preoperative EMG did not correlate with intraoperative nerve stimulation in 13 patients (72%) and did correlate in 5 patients (28%); 3 patients had a nerve transfer (3 thoracodorsal to long thoracic at lateral chest, 1 pec to long thoracic at supraclavicular incision). In the 3 patients who had a nerve transfer, there was return of full forward flexion of the shoulder at an average of 2.5 months.
CONCLUSIONS
A treatment algorithm based on intraoperative nerve stimulation will help guide surgeons in their clinical decision making in patients with isolated long thoracic nerve palsy. Intraoperative nerve stimulation is the gold standard in the management of isolated long thoracic nerve palsy.
Topics: Adolescent; Adult; Brachial Plexus Neuritis; Clinical Decision-Making; Decompression, Surgical; Electric Stimulation; Electromyography; Humans; Intraoperative Period; Middle Aged; Nerve Transfer; Paralysis; Postoperative Complications; Retrospective Studies; Thoracic Nerves; Young Adult
PubMed: 28975819
DOI: 10.1177/1558944717733306 -
The British Journal of General Practice... Nov 2019
Topics: Bell Palsy; Facial Paralysis; Humans
PubMed: 31672833
DOI: 10.3399/bjgp19X706541 -
BMJ Open Jan 2023The aim of the protocol is to present the methodology of a scoping review that aims to synthesise up-to-date evidence on the management and outcomes of facial nerve...
INTRODUCTION
The aim of the protocol is to present the methodology of a scoping review that aims to synthesise up-to-date evidence on the management and outcomes of facial nerve palsy in low-income and middle-income countries (LMICs).
METHODS AND ANALYSIS
The scoping review will be conducted per the Arksey and O'Malley's framework and the Joanna Briggs Institute Reviewers' Manual. The scoping review question, eligibility criteria and search strategy will be developed in accordance to the Population, Concept, and Context strategy. The search will be conducted in electronic bibliographic databases (Medline (OVID), Embase, WHO Global Index Medicus, Cochrane Library, Global Health, African Journals Online). The review will synthesise and report the findings with descriptive statistics and a narrative description of both quantitative and qualitative evidence.
ETHICS AND DISSEMINATION
This scoping review does not require ethical approval. This protocol will describe the proposed scoping review that will map the evidence on the management and outcomes of facial nerve palsies in LMICs. The proposed review aims to collate and summarise published literature to inform policy-makers and healthcare organisations and governments and to identify knowledge gaps that will translate into future research priorities in LMICs.
Topics: Humans; Developing Countries; Facial Nerve; Research Design; Paralysis; Review Literature as Topic
PubMed: 36596636
DOI: 10.1136/bmjopen-2022-065435 -
Journal of Traditional Chinese Medicine... Oct 2014To determine the characteristics and advantages of acupoint-to-acupoint penetrative needling (AAPN) treatment for post-stroke spastic paralysis (PSSP) to improve the... (Review)
Review
OBJECTIVE
To determine the characteristics and advantages of acupoint-to-acupoint penetrative needling (AAPN) treatment for post-stroke spastic paralysis (PSSP) to improve the clinical outcomes of this disease in the future.
METHODS
Randomized, controlled trials of PSSP patients receiving AAPN treatment were searched from MEDLINE, EMBASE, and China National Knowledge Infrastructure Database between January 2006 and June 2013. Key words included: clinic or clinical, acupuncture, needling, acupoint-to-acupoint, penetrative or penetration or penetrating, stroke or apoplexy or cerebral infarction or cerebral hemorrhage, spastic paralysis or spasticity or palsy, and hypermyotonia. Language was limited to English and Chinese. Case series reports, review articles, and, animal studies were excluded.
RESULTS
AAPN showed better clinical results on PSSP than other acupuncture treatments, especially when combined with adjunct therapies such as electroacupuncture, bloodletting, and rehabilitation. The greatest benefit was achieved with rehabilitation combined with penetration from Yang-channel acupoints to Yin-channel acupoints in the upper limbs, and from Yin-channel acupoints to Yang-channel acupoints in the lower limbs with a reinforcing maneuver.
CONCLUSION
AAPN is an effective treatment for PSSP, and it can accelerate and enhance functional repair of PSSP patients.
Topics: Acupuncture Points; Acupuncture Therapy; Clinical Trials as Topic; Humans; Muscle Spasticity; Paralysis; Stroke
PubMed: 25417414
DOI: 10.1016/s0254-6272(15)30071-6