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Pott´s Paraplegia의 治療

Treatment for Pott´s Paraplegia

대한정형외과학회지 1967년 2권 1호 p.75 ~ 87
Ahn,Byung-Hoon,
소속 상세정보
 ( Ahn,Byung-Hoon ) - National Medical Center Department of Orthopedic Surgery

Abstract


Introduction
Tuberculosis of the spine today is uncommon disease in Western countries. In many other countries, however, it still has so high incidence that it represents a constant and important challenge to the orthopaedic profession. The anti¬tuberculosis drugs have made possible a more effective treatment than before and have improved the prognosis but they have not solved all problems. For instance, the most dramatic com¬plication, Pott´s paraplegia, probably is seen today as frequently as before among patients with tuberculosis of the spine and still represents a very serious complication.
The literature on the treatment of tuberculosis of the spine is voltuninous. Only few authros, however, have dedicated their papers to paraplegia as their main subject. The -present author feels
that paraplegia constitutes a so important problem that it deserves a special and separate interest.
For that reason it was felt that a review of the cases of Pott´s Paraplegia treated at Orthopaedic Department, The National Medical Center in Seoul, Korea, in the years 1959 through 1963
might be of some interest. As the treatment included two partly different surgical methods-radical evacuation of tuberculous tissue with and without simultaneous anterior spinal fusion-it was also possible to compare the results and the advantages of these two methods of treament.
Review of Literature
In this review only publications are surveyed in which the treatment of paraplegia is discussed.
Orthodox treatment (constitutional therapy with recumbency, immobilization and additional antituberculosis drugs).
The results are not encouraging. Reasonable degree of recovery in 54 out of 67 with incomplete paraplegia was reported by Sedden (1935) and complete recovery in 10 out of 23 by Alvik (1949). Dobson reported on 136 cases on whom one in every four died and less than half made a worth while recovery.(Griffiths Seddon and Roaf 1956). Orthodox treatment with addition of antitubercu4osis drugs by Kaplan(1959) as 83% recovery as compared to 58 recovery without drugs.
Antero-lateral decompression
Griffithts, Seddon and Roaf (1956) reported in their above mentioned monograph on Pott´s paraplegia the results of antero-lateral decompre¬ssion with 36 recoveries out of 50 paraplegic patients.
Radical evacuation of tuberculous tissue
Radical operation before introduction of antituberculosis drugs was no success. Some patients

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