@rjdm1 When you are talking about cervical myelopathy, it is the pain in the legs that is confusing to a lot of spine surgeons. I had it too, and by also having pain everywhere in my body that was being caused by spinal cord compression in my neck was enough to prevent these surgeons from helping me. They were looking for the pain that follows the dermatome maps that show where each spinal nerve sends it's signals to the surface of the body. The spinal cord is like that giant cable that supplies the internet to a town, and when you crush a part of it, you can't guess who will get their service cut off. The spinal cord conducts communication signals in both directions between the brain and the body. It is called "funicular pain" when there is an unexpected pain such as leg pain from spinal cord compression in the neck. Prior to my spine surgery, I could change where my pain was simply by turning my neck. I had a collapsed C5/C6 disc and bone spurs that pressed into my spinal cord in front. When I read the research papers of a Mayo neurosurgeon, I didn't understand the term, "funicular pain" and I looked it up. Here is the literature I found that explained what all the other surgeons had missed and this highlights a case where the only complaint was leg pain that was caused by cervical cord compression. This is something that is easy for a doctor to miss, and it my case it was missed by 5 specialists. I found this medical literature and contacted a Mayo surgeon with it and I was right. I had funicular pain. My guess is that you probably have it too, and if your specialists don't recognize this possibility, you need other opinions.

This explains dermatome maps and where the nerve pathways go.
https://www.healthline.com/health/dermatome#dermatomes-list
Funicular Pain
https://www.ncbi.nlm.nih.gov/pubmed/20938789
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111492/
To answer your question about if the leg pain resolved after decompression cervical spine surgery, the answer is YES and immediately for me when I woke up from surgery. I knew it would because before I came to Mayo, I had an epidural spine injection and it took away all that pre-existing pain temporarily. If you read the studies in the links, that was the predictor of if decompression spine surgery would resolve the leg pain. That being said, there is no diagnostic test to confirm funicular pain, and surgeons can not promise their surgery will fix it. I also knew prior to surgery, that when my cervical vertebrae were pulled out of alignment by muscle spasms that straightened my neck, it caused me to walk with an uneven gait, and when my physical therapist restored my normal curvature, I walked normally again which is further evidence that my leg function was affected by the spinal cord compression. Effectively the spasms made the spinal canal smaller when it straightened my neck around an already compressed cord.

If you are thinking about your situation just as unrelated neuropathy in your legs, that may lead you down the wrong path in your decision about the benefits of spine surgery. Another factor to consider is that nerves can take compression up to a point, but if it gets worse and goes on longer, at some point nerves will die, and leave permanent disability to any organ that they serviced. Some spine surgeons told me that the spinal cord doesn't feel pain, so don't allow that to be a bases of your thinking about if you do or don't believe that there is a spinal cord problem. Look at the MRI to see if there is any space left around the spinal cord, and consider how that will be affected with movement like bending your neck. If there are bone spurs pressing into the front of the cord, the spinal cord will be stretching across the sharp hard points of bone when you bend your neck forward. Right before my spine surgery, if I did this, I sent an electrical shock down my entire body. I think I was lucky and caught it just in time before permanent damage began. On an MRI, spinal cord damage shows a signal change and looks like a whitish area inside the spinal cord. My MRI did not show that, and I was told that myelopathy doesn't always show on the MRI, but if it is further advanced it will. I suspect the whitish areas of signal changes might suggest permanent damage, but only a specialist can answer that.

Paralysis is definitely a risk if your spinal cord is compressed, and another spine injury in this condition with a tethered cord will add to the problems. If your spinal cord is not floating freely in the spinal fluid with any bending of your spine, you are at increased risk of injury. Only a specialist can advise you on how much risk is present in your circumstances. Other issues are incontinence that can be permanent if decompression surgery isn't done right away. I was warned about that, and had issues with retention that were intermittent and happened when I lost my neck curve to spasms. Questions of adjacent segment disease vary person to person and that also happens to people who have had no surgery. The best you can do is to take care of yourself post surgery and not engage in activities that will put extra pressure on your spine, for example roller coasters. Practice good posture to take pressure off. I do physical therapy with myofascial release to take pressure off my body and loosen surgical scar tissue.

Hardware can be related to increasing the odds of adjacent segment disease because it is more rigid that natural bone (bone can flex), and because a fusion shrinks as it heals, and if the plate on the spine can rub on the next disc, it causes wear. Surgeons have to carefully calculate plate length and the longer the plate, the greater the risk of adjacent segment wear. I chose to have no plate and no hardware which I could do because I needed only one level fused, and I stayed in my neck brace for a few months. Fusing and healing depend on how healthy you are before surgery, and how well you take care of yourself afterward. Smokers have lower fusion rates because of lower oxygen saturation in the bones that are trying to heal. As for revision surgery, there can be a lot of factors. The hardware can fail. Poor bone quality. Screws can back out and implants can migrate. Some patients grow bone around artificial discs and try to stabilize them. This can also happen if a disc collapses and the body tries to stabilize it; the spine fuses itself and that may be a bad thing and can make something inoperable. It's also always good to ask what happens during the normal progression of the problem if no surgical intervention is done. The need for revision surgery can also be due to the skills of the surgeon who did the first procedure. Some are gifted and others are not, so find the very best you can before you commit to surgery. It was frustrating for me to be turned down by several surgeons over two years time, but in the end, I had a much better surgeon and I got my life back and I'm glad I didn't have a procedure with someone else. There can also be immune reactions to any foreign materials in your body. This lab does testing for reactions to implants, but that is something that can happen later down the road too. https://www.orthopedicanalysis.com/ I avoided this by having only a donor bone spacer implanted for my fusion and it healed beautifully. My surgeon told me fusions heal the best without foreign materials. This will be a long journey and recovery. Choose wisely. Let me know if I can be of further assistance. I did a lot of research in the two years that I was looking for help. I had a great recovery and would definitely make this choice if I had it to do again..

Here is my story. https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/