Lomber Pott Kifozu
Özet
27 aylık bir erkek hastada yürüme güçlüğü, kilo kaybı ve sırtta şişlik şikayetleriyle ortaya çıkan L3 seviyesindeki Pott hastalığı (spinal tüberküloz), ciddi nörolojik kayıplara ve kifotik deformiteye yol açmıştır. Yapılan tetkiklerde saptanan psoas ve epidural apseler ile omurga destrüksiyonu nedeniyle hastaya anterior retroperitoneal yaklaşımla L3 korpektomisi ve kemik greftleme işlemi uygulanmıştır. Cerrahi müdahale sonucunda spinal kord üzerindeki bası tamamen kaldırılmış, lokal kifoz açısında %47,6'lık bir iyileşme sağlanmış ve hasta iki haftalık süreçte destekle mobilize olarak taburcu edilmiştir.
A 27-month-old male presented with walking difficulties, weight loss, and a spinal deformity caused by Pott's disease (spinal tuberculosis) at the L3 level, resulting in significant neurological deficits. Due to the presence of psoas and epidural abscesses along with vertebral destruction, the patient underwent an anterior retroperitoneal L3 corpectomy and bone grafting. Post-surgery, the spinal cord was fully decompressed, a 47.6% improvement in the local kyphosis angle was achieved, and the patient was successfully mobilized with a brace within two weeks.
Referanslar
Kotil k, Alan MS, Bilge T. Medical management of Pott disease in the thoracic and lumbar spine: a prospective clinical study. Neurosurg Spine 2007 March; 6(3):222-8
Griffith DL. Potts paraplegia and its operative treatment: J. Bone Joint Surg: 35 -B,487.1953
Oguz E, Sehirlioglu A, Altinmakas M, et al. A new classification and guide for surgical treatment of spinal tuberculosis. Int Orthop 2008;32:127-33
Özdemir HM, Us AK, Öğün T. The Role of Anterior Spinal Instrumentation and Allograft Fibula for the Treatment of Pott Disease. Spine 2003;28: 474–479
Jain AK: Treatment of Tuberculosis of the spine with neurological complications. Clin. Orthop. Relat res. 2002; (398):75 .
Anand MG, Kumar GP, Ku K. Evaluation of functional and Radiological outcome of anterior spinal decompression and stabilisation in the thoracolumbar potts’s spine: A prospective study. Int J of Orthop Sci 2020; 6(3): 01-05
Consigilieri G, Kakarla UK, Theodore N. Pott Disease in a 13-Month-Old: Case Report. Neurosurgery 2011; 68(5):1485-1490