Date of Award

Summer 2026

Degree Name

Doctor of Physical Therapy

Department

Physical Therapy; College of Health Sciences

First Advisor

Kerstin Palombaro

Abstract

Background and Purpose: Postoperative C5 palsy is a known problem after cervical spinal surgery and is characterized by upper extremity weakness that can significantly limit the ability to perform daily tasks. Despite its clinical relevance, limited literature describes physical rehabilitation-focused interventions strategies for this condition. The purpose of this case report is to describe the presentation, physical therapy intervention, and outcomes of a patient with postoperative C5 palsy managed with neuromuscular re-education.

Case Description: The patient is an adult who developed left upper extremity weakness consistent with C5 palsy following cervical spinal surgery. Primary impairments included decreased shoulder abductor and elbow flexor muscle strength, sensory impairments and reduced functional use of the left upper extremity. A comprehensive physical therapy evaluation guided the development of a plan of care emphasizing neuromuscular re-education, muscle strengthening, and functional mobility training.

Outcomes: Over the course of rehabilitation, the patient has shown gradual improvements in left upper-extremity strength, sensation, and functional performance. Improvements were documented through clinical examination findings and standardized outcome measures, with corresponding gains in participation in activities of daily living and instrumental activities of daily living.

Discussion: This study highlights the role of neuromuscular re-education in the rehabilitation management of postoperative C5 palsy. Intensive physical therapy intervention may support recovery of overall function. This case contributes to the limited rehabilitation articles addressing postoperative C5 palsy and provides more information clinically for physical therapists who have similar cases.

Comments

This case report describes the successful rehabilitation of a patient with postoperative C5 palsy following cervical spine surgery. Intensive physical therapy focused on neuromuscular re-education significantly improved upper extremity strength and function, leading to meaningful gains in activities of daily living and instrumental activities of daily living. The case contributes to the limited existing literature on effective rehabilitation strategies for this uncommon but debilitating complication.

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Effect on C5 Myotome Distribution After Cervical Spinal Surgery: A Case Report on Early Neuromuscular Re-education

Background and Purpose: Postoperative C5 palsy is a known problem after cervical spinal surgery and is characterized by upper extremity weakness that can significantly limit the ability to perform daily tasks. Despite its clinical relevance, limited literature describes physical rehabilitation-focused interventions strategies for this condition. The purpose of this case report is to describe the presentation, physical therapy intervention, and outcomes of a patient with postoperative C5 palsy managed with neuromuscular re-education.

Case Description: The patient is an adult who developed left upper extremity weakness consistent with C5 palsy following cervical spinal surgery. Primary impairments included decreased shoulder abductor and elbow flexor muscle strength, sensory impairments and reduced functional use of the left upper extremity. A comprehensive physical therapy evaluation guided the development of a plan of care emphasizing neuromuscular re-education, muscle strengthening, and functional mobility training.

Outcomes: Over the course of rehabilitation, the patient has shown gradual improvements in left upper-extremity strength, sensation, and functional performance. Improvements were documented through clinical examination findings and standardized outcome measures, with corresponding gains in participation in activities of daily living and instrumental activities of daily living.

Discussion: This study highlights the role of neuromuscular re-education in the rehabilitation management of postoperative C5 palsy. Intensive physical therapy intervention may support recovery of overall function. This case contributes to the limited rehabilitation articles addressing postoperative C5 palsy and provides more information clinically for physical therapists who have similar cases.