The objective of this study was to examine the association between electrophysiology data post-C5-palsy and referral to peripheral nerve surgeons (PNS) using a 15-year cohort of patients who underwent posterior cervical decompression. Endpoints included the associations of postoperative treatments employed with functional recovery and abnormal electrophysiology data. Of 77 included patients (median 64 yr; 68% male), 48% completely recovered. The most common treatments were physical therapy (90%), occupational therapy (34%), oral corticosteroids (18%), and PNS referral (17%). Baseline weakness did not associate with PNS referral or postoperative treatment strategy. None of the treatments predicted recovery, though patients with no [versus complete] recovery were more likely to be recommended for nerve transfers (22.2 vs 0%; p = 0.03). Abnormal electromyography data associated with PNS referral (p < 0.01), nerve transfer recommendation (p < 0.01), occupational therapy referral, and oral corticosteroid therapy. Abnormal findings on EMG obtained between 6-weeks and 6-months post-injury were the most strongly associated with peripheral nerve surgeon referral (p = 0.02) and nerve transfer recommendation (p < 0.01). These data suggest strategies for postoperative C5 palsy management are highly heterogeneous. None of the treatments employed significantly predicted the extent of functional recovery. However, patients with abnormal electrophysiology results were most likely to receive multimodal treatment, suggesting these results may significantly alter medical management of patients with postoperative C5 palsy. Early (6-week to 6-month) electrophysiology data may help to ensure that patients likely to benefit from nerve transfer procedures are referred to a PNS within the 9–12-month time frame associated with the best recovery of function.

本研究的目的是使用 15 年接受后路颈椎减压术的患者队列来检查 C5 麻痹后的电生理数据与转诊至周围神经外科医生 (PNS) 之间的关联。终点包括术后治疗与功能恢复和异常电生理数据的关联。在纳入的 77 名患者中（中位年龄为 64 岁；68% 为男性），48% 的患者完全康复。最常见的治疗方法是物理治疗 (90%)、职业治疗 (34%)、口服皮质类固醇 (18%) 和 PNS 转诊 (17%)。基线弱点与 PNS 转诊或术后治疗策略无关。尽管没有[相对于完全]恢复的患者更有可能被推荐进行神经移植（22.2 vs 0%；p = 0.03），但没有一种治疗能预测康复。与 PNS 转诊 (p < 0.01)、神经转移推荐 (p < 0.01)、职业治疗转诊和口服皮质类固醇治疗相关的异常肌电图数据。在受伤后 6 周和 6 个月之间获得的 EMG 异常发现与周围神经外科医生转诊 (p = 0.02) 和神经转移推荐 (p < 0.01) 的相关性最强。这些数据表明术后 C5 麻痹的管理策略是高度异质的。所采用的治疗均未显着预测功能恢复的程度。然而，电生理结果异常的患者最有可能接受多模式治疗，这表明这些结果可能会显着改变术后 C5 麻痹患者的医疗管理。