[Pott's disease paraplegia in children. Mechanics and therapeutic strategies. Six cases].
OBJECTIVE
We report a series of 6 Pott's disease paraplegias treated between 1982 and 1996.


METHODS
Out of 15 children suffering from Pott's disease, 6 had paraplegia. Treatment consisted of anterior medullar decompression and anterior spine fusion with bone grafting. Two or three weeks later, posterior spine fusion was achieved systematically using a CD fixation device in 3 cases.


RESULTS
Neurological signs completely disappeared in 5 children. Vertebral fusion was correct in all patients and kyphosis was less than 50 degrees.


CONCLUSIONS
The posterior approach to the spine must be proscribed as a first step, except for spine dislocation. The anterior approach allowed us to drain the abscess, to correct the kyphosis, and to perform an anterior spine fusion. The posterior spine fusion was performed a few weeks later in order to avoid kyphosis aggravation.


CONCLUSIONS
Prognosis of Pott's disease is good but at the present time, paraplegia remains too frequent. Adapted treatment must be performed without delay.
Service d'Orthopédie Traumatologie Infantile, Hôpital des Enfants Malades, Paris.
P
P
Journeau
A
A
Koura
P
P
Mary
J P
JP
Padovani
P
P
Touzet
D000367:Age Factors; D001696:Biomechanical Phenomena; D002648:Child; D002675:Child, Preschool; D019299:Decompression, Surgical / Q000379:methods; D016267:External Fixators; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D010264:Paraplegia / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000503:physiopathology / Q000601:surgery*; D011859:Radiography; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae; D013997:Time Factors; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000150:complications*
Paraplégie d'origine pottique chez l'enfant. Mécanismes et stratégies thérapeutiques. A propos de 6 cas.