Bilsel N, Aydingöz O, Hanci M, Erdogan F
Department of Orthopaedics and Traumatology, Cerrahpaşa Faculty of Medicine, University of Istanbul, Turkey.
Spinal Cord. 2000 Nov;38(11):669-74. doi: 10.1038/sj.sc.3101082.
Pott's disease may cause late neurological involvement due to development of sharp kyphosis. Anterior decompression and fusion is the treatment of choice for this disorder.
To determine the mid-term clinical results of patients with late onset Pott's paraplegia, who underwent anterior decompression and grafting after neurological deterioration.
A university hospital in Istanbul, Turkey.
Eight patients who developed late onset paraplegia with a mean period 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 deterioration before surgery was 7.4 weeks (range, 2-13 weeks). The mean kyphosis angle 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 patients' neurological status were evaluated according to the International Standards for Neurological and Functional Classification of Spinal Cord Injury determined by ASIA-IMSOP on admission.
Neurological status of all patients showed progression either in Frankel scale or in motor scores in the early postoperative period. One patient needed to be reoperated on because of a deterioration of neurological status 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 out their lives independently with a mean motor score of 97.5 and full pin-prick and light touch scores.
Anterior decompression and grafting is an effective procedure for the treatment of late onset paraplegia in Pott's disease.
由于严重驼背的发展，波状热可能导致晚期神经受累。前路减压融合术是治疗该疾病的首选方法。
确定晚期波状热截瘫患者在神经功能恶化后接受前路减压植骨术的中期临床结果。
土耳其伊斯坦布尔的一家大学医院。
8例在活动性疾病后平均24.6年（范围9 - 46年）出现迟发性截瘫的患者接受了前路减压植骨术治疗。手术时的平均年龄为36.1岁（范围18 - 63岁），术前神经功能恶化的平均持续时间为7.4周（范围2 - 13周）。患者的平均驼背角度为105.63度（范围80度 - 135度）。所有手术均未尝试矫正脊柱侧弯。除两名患者外，所有患者入院时均根据亚洲脊髓损伤学会国际脊髓损伤神经和功能分类标准进行神经功能评估。
所有患者的神经功能在术后早期Frankel分级或运动评分方面均有进展。1例患者在术后26个月因神经功能恶化需要再次手术。手术至今的平均时间为75.9个月（范围48 - 173个月），所有患者均能独立生活，平均运动评分为97.5分，针刺觉和轻触觉评分均正常。
前路减压植骨术是治疗晚期波状热截瘫的有效方法。
