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.
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