PT - JOURNAL ARTICLE AU - Andrew M. Sinensky AU - Ian D. Kaye AU - William T. Li AU - Scott C. Wagner AU - Joseph S. Butler AU - Arjun S. Sebastian AU - Patrick B. Morrissey AU - Gregory D. Schroeder AU - Christopher Kepler AU - Alexander R. Vaccaro AU - Alan S. Hilibrand TI - Radiographic Measures of Spinal Alignment Are Not Predictive of the Development of C5 Palsy Following Anterior Cervical Discectomy and Fusion Surgery AID - 10.14444/8029 DP - 2021 Mar 31 TA - International Journal of Spine Surgery PG - 8029 4099 - http://ijssurgery.com//content/early/2021/03/30/8029.short 4100 - http://ijssurgery.com//content/early/2021/03/30/8029.full AB - Background Postoperative C5 palsy is a common complication following cervical decompression, occurring more frequently after posterior-based procedures. It has been theorized that this is the result of C5 nerve stretch resulting from spinal cord drift with these procedures. As such, it is thought to be less common after anterior cervical decompression and fusion (ACDF). However, no consensus has been reached on its true etiology. The purpose of this study is to assess the rate of C5 palsy following ACDF and to determine whether any radiographic or demographic parameters were predictive of its development.Methods Two hundred and twenty-six patients who received ACDF between September 2015 and September 2016 were reviewed, and 122 were included in the final analysis. Patient demographic, surgical, and radiographic data were analyzed, including preoperative and postoperative radiographic and motor examination results. The Mann-Whitney U test was used to compare continuous variables between independent groups, and Fisher's exact test was used to compare categorical variables between groups.Results Seven patients developed a C5 palsy in the postoperative period, an incidence rate of 5.7%. Among the radiographic parameters evaluated, there were no statistically significant differences between the C5 palsy and nonpalsy groups. Additionally, there were no statistically significant differences in age, patient sex, or numbers of vertebral levels fused between groups.Conclusions Ultimately, we did not identify any statistically significant demographic or radiographic predictive factors for the development of C5 palsy following ACDF surgery.Level of Evidence 3.