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One-stage lateral rhachotomy and posterior spinal fusion with compression hooks for Pottâ€™s paralysis in the elderly
Journal of Orthopaedic Surgery 2006;14(3):310-4 B Wang, H Ozawa, Y Tanaka, F Matsumoto, T Aizawa, S Kokubun
Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
Purpose. To evaluate the safety and effectiveness of
one-stage lateral rhachotomy and posterior fusion
with compression hooks, for the treatment of Pottâ€™s
paralysis in the elderly.
Methods. 11 elderly patients underwent lateral rha-
chotomy (costotransversectomy and pediculectomy)
to debride the tuberculosis focus extending into the
epidural space and to decompress the spinal cord.
After debridement, the interbody cavity was packed
with autologous iliac bone chips. For stabilisation,
posterior fusion was performed using a compression
lamina hook system. Patients were followed up for
at least 2 years for complications. Neurological status
was assessed using the Frankel score. The kyphotic
deformity was measured on lateral radiographs
taken before surgery and at follow-up.
Results. During separation of the adhesion around
the abscess, a dural tear occurred in one patient and
a pleural tear in another. Both tears were successfully
repaired. One patient had mild pneumonia after
surgery. The Frankel scores of the 11 patients
improved from C or D before surgery to D or E after surgery. No relapse of spinal tuberculosis was
encountered. The mean deformity angle was 25.5
degrees before surgery and 23.2 degrees at the final
follow-up. Spinal fusion was achieved in all patients.
Conclusion. Without the need of thoracotomy, one-
stage lateral rhachotomy with posterior spinal fusion
using compression hooks was an effective option for
treating Pottâ€™s paralysis in the elderly.
Type: Reference Material
Author/Contact: Wang et al
Submitted by: admin
Added: Wed Oct 10 2007