C5 Palsy after Cervical Disc Arthroplasty: Two Case Reports and Literature Review

Cervical disc arthroplasty (CDA), also known as cervical artificial disc replacement, has become an alternative for the treatment of cervical spondylosis with radicular or myelopathic symptoms. However, there is limited literature regarding its complications and outcomes. We present two cases that developed C5 nerve palsy (C5P) following two-level CDA. Both patients presented with C5P in a delayed fashion with 2/5 and 1/5 deltoid weakness on MMT, respectively. Postoperative imaging did not demonstrate any spinal cord compression and symptoms resolved (5/5 on MMT) with conservative management in both cases. To our knowledge, these represent the first cases of delayed C5P after cervical arthroplasty reported in the literature. We performed a literature review to further enhance our knowledge regarding CDA. By understanding its pathophysiology and response to treatment, these cases can serve as a guide for spine surgeons and improve their future outcomes.