Surgical Decompression in Pott's Paraplegia Patients by Anterior Approach

Abstract

Background: Spinal tuberculosis is the most serious form of skeletal tuberculosis. Most of the patients with pott’s spine or grade I and II pott’s paraplegia responds well to chemotherapy alone but patients with grade III and IV paraplegia and those patients with grade I and II paraplegia, who do not responds to conservative treatment need urgent surgical decompression to avoid irreversible damage to spinal cord. Material and method: This study is based on 13 patients with preoperative diagnosis of grade III and grade IV Pott’s paraplegia, who did not respond to three to four weeks of conservative therapy or deteriorated neurologically during treatment and were treated by anterior decompression and fusion, at department of orthopaedics, JN Medical College, AMU Aligarh. Results: Out of 13 patients 10 patients recovered & among these complete recovery was seen in 8 patients while 2 patients had partial recovery. Two patients didn’t show neural recovery until last follow up & one patient deteriorated after anterior decompression. Conclusion: Early decompression of cord by anterior approach in patient with grade III & grade IV paraplegia gives satisfactory results in terms of early recovery, short period of hospitalization, early mobilization & healing of the lesion. With this approach adequate exposure can be obtained and post operative rehabilitation of patients is better.