Pott's paraplegia: an account of the treatment of 89 consecutive patients.
The results of the treatment of 89 consecutive cases of Pott's paraplegia admitted to care in Korea are reported. Eighty-five patients were treated conservatively. Four patients underwent costo-transversectomy, three of them in the later stages of treatment without apparent benefit. All patients were followed-up for more than one year, 22 (25%) of them for five years or more. 75 patients (84%) recovered sufficiently to walk unaided. 74 patients (83%) returned to normal life and full activity. 64 of these (72%) were neurologically and functionally completely normal and, at the end of follow-up, the other ten (11%) had minimal persistent neurological signs not affecting life and activity. 54 patients (61%) spent less than six months in hospital and 56 (63%) returned to normal activity within one year of the start of treatment. There were two deaths. 41 patients (46%) deteriorated neurologically during the first two months of treatment, but 37 of these recovered completely. The place of chemotherapy as the basis of the treatment of Pott's disease is emphasised. A comparison is made with the published results of other series. The place of operative intervention is discussed and it is argued that the case for urgent early surgical intervention in the treatment of Pott's paraplegia may have been overstated.
Pattisson
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PR
D000038:Abscess / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000628:therapy*; D013904:Thoracic Vertebrae / Q000601:surgery; D014399:Tuberculosis, Spinal / Q000628:therapy*
D000995:Antitubercular Agents