Risk of C5 nerve root palsy in cervical myelopathy patients comparing anterior and posterior procedures: A Systematic review and Meta-analysis

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Bancha Chantarasongsuk
Isareethika Jayasvasti Chantarasongsuk
Surachai Sae-Jung
Kriangkrai Wittayapairoj
Kitti Jirarattanaphochai


Anterior or posterior decompression is recommended for cervical myelopathy. The C5 nerve root palsy is one of the common complications from these procedures. However, the risk of C5 nerve root palsy associated with these procedures is still moot. Therefore, the risk of C5 palsy comparing anterior (anterior discectomy and fusion (ACDF), and anterior corpectomy and fusion (ACCF)) and posterior procedures (laminoplasty and laminectomy) in cervical myelopathy patients was systematically reviewed and meta-analyzed. We thoroughly searched MedLine and Scopus database without restricted date of the publication until 2021. Any studies those met inclusion and exclusion criteria were included to the present meta-analysis. Data from each study were collected. Odds ratio with 95% confident interval was calculated from each study and pooled data. The result was showed in Forest plot. Funnel plot was drawn to evaluate potential publication bias. The results of 1,039 studies showed that 16 studies were met inclusion and exclusion criteria. The outcomes showed that ACDF group had the lowest risk of C5 nerve root palsy (pooled odds ratio =0.27, 95%CI=0.13-0.55 when compared with ACCF), followed by ACCF and laminoplasty groups which had the same risks (pooled odds ratio = 0.34, 95%CI= 0.24-0.50), Laminectomy group had the highest risk of C5 nerve root palsy (Laminoplasty compared with Laminectomy, pooled odds ratio = 0.35, 95%CI = 0.14 – 0.90 and ACCF compared with Laminectomy, pooled odds ratio = 0.37, 95%CI = 0.21 – 0.66). Funnel plot showed no publication bias. The results of this study provide useful information in choosing the appropriate treatment for each patient's pathology.


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Chantarasongsuk , B. ., Chantarasongsuk, I. J. ., Sae-Jung , S. ., Wittayapairoj , K. ., & Jirarattanaphochai, K. (2022). Risk of C5 nerve root palsy in cervical myelopathy patients comparing anterior and posterior procedures: A Systematic review and Meta-analysis. Journal of Medical and Public Health Region 4, 12(1), 40–54. Retrieved from https://he01.tci-thaijo.org/index.php/JMPH4/article/view/251826
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