PREVENTION OF POSTOPERATIVE LATE KYPHOSIS IN POTTS-DISEASE BY ANTERIOR DECOMPRESSION AND INTERVERTEBRAL GRAFTING

A total of 185 patients with Pott's disease were operated on between 1 973 and 1992. Anterior decompression by preserving the pleura (extrapl eural approach) was the preferred method in the thoracic spine. In the lumbar spine the approach was retroperitoneal, and interbody fusion w as 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 a nd intervertebral grafting. The aim of instrumentation was to enhance anterior spinal stability, and Alici spinal instrumentation was the pr eferred device. Graft destruction and a late increase in kyphosis was prevented by this means. The mean follow-up period was 7.5 years. Thir ty-two of the cases were admitted to the clinic because of Pott's para plegia: 19 of the cases recovered completely following anterior decomp ression; 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.