Two different types of clinical picture are described.
An early-onset paresis due to pressure by an abscess or bony sequestration. A myelogram will usually show a block in the cord. If this is treated early by anterior decompression and debridement followed by spinal fusion, then there is an 80% recovery rate within a few weeks.
Late-onset paresis is due to an increasing deformity, or reactivation of disease, or vascular insufficiency of the cord. If a myelogram does not show a block then an operation is not likely to be of any use.
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