[Pott's disease paraplegia in children. Mechanics and therapeutic strategies. Six cases].

PURPOSE: We report a series of 6 Pott's disease paraplegias treated between 1982 and 1996.

MATERIALS AND METHOD: 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.

DISCUSSION: 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.

CONCLUSION

Prognosis of Pott's disease is good but at the present time, paraplegia remains too frequent. Adapted treatment must be performed without delay.