Pott's disease in African
Ferro, R.M.; Barnaud, P.; Carayon, A.
Medecine Tropicale Revue du Corps de Sante Colonial 39(2): 191-208
1979
ISSN/ISBN: 0025-682X PMID: 491910 Document Number: 142898
A study of anatomical clinical, and therapeutic features of Pott's disease in Africans from 131 cases treated by the same team and compiled from the principal series published during the last ten years in Black Africa. Anatomical features are related to the frequency of the disease (70 p. 100 of tuberculous osteo-arthritis), the elective lumbodorsal localization involving several vertebrae (gpenerally 3 or 4) and being sometimes multifocal. Clinical features are in part explained by the delay with which patients report to the hospital for the first time so that 80 to 90 p. 100 of the patients suffer from severe lesions (which are in their destructive phase in 30 p. 100 of the cases), with associated-complications (gibbosity, abcess, 50 p. 100; fistulae, 2 to 6 p. 100; paraplegie 23 to 25 p. 100; multiplefoci, 4 to 13 p. 100). Diagnostic difficulty mainly raised by "False Pott's diseases" (P. Bourrel), is considered. Therapeutics is studied; importance and place of the surgical treatment is emphasized; its various approaches are discussed. The authors report their surgical interventions on 89 patients out of 181 admitted: 64 direct approaches for simple Pott (with 70 p. 100 of good results and 20 p. 100 of satisfactory results), 25 operations for complicated cases of Pott (18 approaches for antero-lateral decompression and 5 laminectomies, with 22 satisfactory results).