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How can Paget disease of bone affect the skull, spine, and nerves?

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bone disease Defect of tibia, caused by septic osteomyelitis in childhood, with compensatory thickening of the fibula (right). Normal bones are shown at left.

Paget disease of bone is a chronic condition characterized by disorganized bone remodeling, which leads to weakened, deformed, and brittle bone tissue. When this disease affects the skull and spine, it can have serious neurological consequences due to bone overgrowth and structural changes.1

Impact on the Skull and Spine

Skull: Overgrowth of the skull bones can occur, often resulting in a noticeably enlarged head.1
Spine: The disease frequently affects the vertebral column, which may lead to a shortened spine and structural deformities.1

Effects on Nerves

The primary way Paget disease affects the nervous system is through the physical impingement of overgrown or softened bone on neural structures. As the bone structure becomes chaotic or undergoes softening, it can compress the spinal cord or emerging nerve roots. This compression often results in significant pain, as well as potential weakness or numbness in the affected areas. In some cases, the bone-destructive phase of the disease causes the bone to soften, further increasing the risk of cord or root compression.12