Late onset Pott's paraplegia

Background: Pott's disease may cause late neurological involvement due to d evelopment of sharp kyphosis. Anterior decompression and fusion is the trea tment of choice for this disorder. Objective: To determine the mid-term clinical results of patients with late onset Pott's paraplegia who underwent anterior decompression and grafting after neurological Setting: A university hospital in istanbul, Turkey. Methods: Eight patients who developed late onset paraplegia with a mean per iod of 24.6 years (range, 9-46 years) after the active disease were treated with anterior decompression and grafting. The mean age at surgery was 36.1 years (range, 18-63 years) and the mean duration of neurological deteriora tion before surgery was 7.4 weeks (range, 2-13 weeks). The mean kyphosis an gle of the patients was 105.63 degrees (range, 80 degrees -135 degrees). No attempt to correct the curve was made in any operation. All but two patien ts' neurological status were evaluated according to the International Stand ards for Neurological and Functional Classification of Spinal Cord Injury d etermined by ASIA-IMSOP on admission. Results: Neurological status of all patients showed progression either in F rankel scale or in motor scores in the early postoperative period. One pati ent needed to be reoperated on because of a deterioration of neurological s tatus 26 months after surgery. The mean length of time since the operations is 75.9 months (range, 48-173 months) and all the patients are carrying ou t their lives independently with a mean motor score of 97.5 and full piu-pr ick and light touch scores. Conclusions: Anterior decompression and grafting is an effective procedure for the treatment of late onset paraplegia in Pott's disease.