[Medical Management of Pott's disease: a review of 18 cases]

ABSTRACT

Vertebral tuberculosis is the most frequent osteo-articular location, surgical treatment is rarely indicate. The duration and the modalities of the medical treatment remain however subject to discussion. The purpose of this study is to propose a therapeutic attitude standardized for the pott's disease. The authors report a retrospective analysis of 18 cases of pott's disease. The mean age was 51 years. All the patients have a medical treatment, no surgical indications were carried. Magnetic resonnance imagery and biopsy under scanner allowed to avoid the surgical approach with aim diagnosis. The chemotherapy consisted of an attack phase associating four antituberculosis antibiotics of an average duration of 5 months, followed by a maintenance phase associating only two major antituberculosis antibiotics in daily grip and of an average duration of 11 months. Eight patients had a spinal cast immobilization. The mean follow up was 36 months. Clinical and anatomical evolution was favorable for all the patients. No neurological complication was noted. The antituberculosis medical treatment is always effective especially if diagnosis is premature and allows so to avoid appeal to the rather laborious surgery and results of which are not encouraging