Pott's disease and extrapleural anterior decompression. Results of 108 consecutive cases

Between 1973 and 1988, 108 patients with a preoperative diagnosis of spinal tuberculosis were treated by anterior extirpation and interbody fusion at Ankara University Medical Faculty, Orthopedic Surgery and Traumatology Department. In 96 cases the operations were performed intrapleurally, as Hogston described. For 12 patients who had spinal involvement at lower thoracic and upper lumbar segments an extrapleural and extraperitoneal approach was used. The extrapleural approach is strongly recommended for patients who have compromised pulmonary reserve. When this approach is used adequate exposure can be obtained and postoperative rehabilitation of patients is facilitated. Advantages and disadvantages of the extrapleural approach and the results obtained from 108 patients are presented.