Dr Adriaan Liebenberg My Spine Explained | Page 39

My Spine Explained How is it treated? The clinical deterioration in myelopathy can usually not be reversed but only halted. This is only achieved by surgery. Mild improvement can occur, but is not guaranteed. The treatment consists of surgical decompression of the spinal cord and the nerves that arise from the spinal cord. The operation can be from the front of the spine and these operations are called discectomies and corpectomies and are usually accompanied by an intervertebral fusion. Sometimes the operation is done from the back and these operations are called a laminectomy and laminoplasty and they may sometimes be accom- panied by a posterior spinal fusion. A posterior cervical fusion is performed if the surgery to decompress the nerves is so extensive that it leaves the spine unstable. Does this treatment have any complications? Managing this condition without surgery almost always leads to a progression in the symptoms of the patient. Should surgical treatment not be performed, the clinical symptoms can remain unchanged for long periods of time, but sudden deterioration can occur without warning. The surgical management carries rare, but potentially serious complications. Some of the most feared risks would include nerve damage, which may be damage to the nerves leav- ing the spinal canal or damage to the spinal cord itself. The potential effects of this could be partial or complete dysfunction of these nerves and can include numbness, pain and weakness of the muscles or com- plete paralysis of one or more muscle groups. Infection and the formation of blood clots are also possible complications. Speech impediments can be caused by traction or damage to certain nerves. 38