Türk Nöroşirürji Dergisi 2001 , Vol 11 , Num 1
A. Murat MÜSLÜMAN1, İbrahim M. ZİYAL2, Adem YILMAZ1, Aydın CANPOLAT1, Hüdayi DUMAN1, Yüksel ŞAHİN1, Yunus AYDIN1
1Şişli Etfal Hastanesi Nöroşirürji Kliniği, İstanbul
2AİBÜ Düzce Tıp Fakültesi Nöroşirürji Anabilim Dalı, Düzce
This retrospective study includes surgical results of 26 cases with Pott's disease and discusses factors affecting the surgical results. Pulmonary tuberculosis was diagnosed in 9 cases (34 %). The localizations of spinal lesions were as follows: thoracal spine in 11 cases (42 %), cervical spine in 9 cases (35 %) and lumbar spine in 6 cases (23 %). Four cases were neurologically intact (15.4 %). Twenty-two cases (84.6 %) had different degree ot neurological deficits. Instability was discovered in fourteen cases radiologically (53.8 %). The criteria for the operation was having neurological deficit and lor instability. Thirty procedures were performed on 26 cases. Anterior approach for 8 cases with cervical tuberculosis, and from 17 cases with thoraco-lumbar tuberculosis, posterior approach for 9 cases and anterior approach for 8 cases were chosen. Mean follow up period of this series is 38 months (from 14 months to 68 months). The recovery rate according to Frankel citeria is 92.3 %. Postoperative morbidity rate is 4% with a mortality rate of 0%. Two cases (7.7 %), one in cervical spine and the other one in thoracal spine had recurrence (reactivation of the infection). In conclusion, cases with neurological deficit and instability should be treated surgically. The results of surgical treatment is multifactorial and each factor should be determined individually. The usefullness of anterior instrumentation shouldn't be neglected. Anahtar Kelimeler : Pott's disease, spinal instabilite, spinal tuberculosis, surgery