SURGICAL-TREATMENT OF POTTS PARAPLEGIA IN AN ADULT - OUR EXPERIENCE IN GABON

Twenty-six of 95 adults treated for tuberculous spondylitis, between 1 982 and 1993, underwent surgery. Twenty-one exhibited neurological def icits: radicular deficits: 4, and progressive spinal cord syndromes: 1 7 (incomplete: 13, complete, of acute onset: 4). Vertebral body compre ssion fracture was the most prominent finding. Indications for surgery were neurologic: 11, mechanical: 1, etiologic: 1, and mixed: 13. Twel ve patients had vertebrectomies, 3 laminotomies and 11 laminectomies. The average follow-up was 23 months. The neurological recovery was com plete in 16 cases, partial in 4 cases and unchanged in one case. Bony consolidation occurred after 3-5 months. The medicosurgical treatment produced a Very high cure rate, so rapidly, that it became the treatme nt of choice in our setting. Moreover, that allows to specify the diag nosis. Anterior decompression and fusion is recommended in the cervica l and lumbar spine. In the thoracic segment, significant kyphosis is i nfrequent, so that surgical correction is rarely necessary. Laminotomy may occasionally be indicated for posterior decompression for abscess . Laminectomy is now preferred for uncommon cases of thoracolumbar pos terior compression by tuberculous arachnoiditis or associated posterio r Vertebral tuberculosis. Indications for open biopsy are discussed.