Surgical Treatment In Pott's Paraplegia

Son, Young Chan; Son, Jung Hwan; Park, Jae Gong; Choi, Jang Suk; Lee, Young Goo

Abstract

Pott's paraplegia has been frequently serious complication of tuberculous spondylitis, although antituberculous drugs have improved the prognosis and healing of the disease. There are much controvercy on treatement of Pott's paraplegia, which comprises immobilization with or without anterolateral antituberculous drugs, immobilization and early posterior arthrodesis, anterolatear decompression and radical anterior decompression with anterior spinal fusion. The method of anterior decompression and anterior interbody fusion which was introduced by Hdgson since 1956 has good reults. The author analyzed 27 consecutive cases of Pott's parsplegia operated at orthopedic departement, In Je Paik Hospital from May 1980 to August 1988. The results were as follows, 1. Number of cases in child was nine(33%), both sexes were similar. 2. Regions of spine involved were most common at thoracic spine(62%). Number of affected vertebrae was averaged 3.3 vertebrae. 3. There were nineteen early(70%) and eight late(30%) paraplegia. 4. There were two complete and twenty five incomplete paraplegia. 5. In operative finding, inflammatory products and sequestrated material was extrinsic factor in early in paraplegia. 6. The recovery of the paraplegia occur in twenty cases(74%) 7. The recovery of paraplegia after treatment was far better in type of early onset, type of incomplete paraplegia less than one year duration. 8. The radical anterior decompression and anterior interbody fusion was considered as recommendable method for remove of all pathologic foci, recovery of paraplegia and healing the tuberculosis with stability.