Prevention of Postoperative Late Kyphosis in Pott's Disease by Anterior Decompression and Intervertebral Grafting

Abstract

A total of 185 patients with Pott's disease were operated on between 1973 and 1992. Anterior decompression by preserving the pleura (extrapleural approach) was the preferred method in the thoracic spine. In the lumbar spine the approach was retroperitoneal, and interbody fusion was performed in both for the thoracic and the lumbar regions. Anterior decompression and intervertebral grafting comprised the treatment. In five patients, internal fixation accompanied anterior decompression and intervertebral grafting. The aim of instrumentation was to enhance anterior spinal stability, and Alici spinal instrumentation was the preferred device. Graft destruction and a late increase in kyphosis was prevented by this means. The mean follow-up period was 7.5 years. Thirty-two of the cases were admitted to the clinic because of Pott's paraplegia: 19 of the cases recovered completely following anterior decompression; partial recovery was observed in 5 cases; but 8 cases did not recover. Various complications, including seven deaths, were observed in 42 of the cases.