To Export One-stage Posterior Operation For Treatment Of The Thoracic And Lumbar Brucella Spondylitis

Objective :To investigate the clinical effect of one-stage posterior operation for the treatment of the thoracic and lumbar Brucella spondylitis.Methods:To review 36 cases of Brucella spondylitis patients in our department from January 2010 ~ march 2014, 3 cases thoracic patients, 33 cases with lumbar. Male 26 cases, fe male 22 cas-es, age 29 to 65 years old, average 42 years old. Patients with dru-g cons ervative treatment of chest and back, lumbosacral pain and nerve compression s-ympt oms without apparent ea-se, with One-stage posterior debridement and bone graft fusi on combined with pedicle inter-nal fixation. Postoperative pathology and bacterial cu ltures were confirmed to be brucellosi-s,continue to offer standard drug therapy after s urgery.Comparison patients between preoper-ative and postoperative 1 month,3month s,6months,12 months visual analogue score(VAS),ODI index, neural function Frankel cl-assification further evaluation of the patient’s clinical curative effect.After postope rati-ve 3 month, 6months,12 months for imaging examination a-ssessment of patients bone graft fusion.Results:This group of patients were successfully completed surgery,intraoperative d-oes not appear related complications,follow-up of 9 to 24 months,an average of 12 m-onths.On preopera-tive and postoperativ e 1 month,3months,6months,12 months for vis-ual analogue score(VAS), Oswestry Disability Index(ODI).VAS results respectively i-s(8.3±0.8)、(2.7±1.5)、(1.7±0.9)、(0.9±0.5)and 0,ODI index is 80 ± 0.5.ODI VAS results respectively is(83.1±3.8)、(24.6±1.9)、(20.1±3.0)、(18.6±1.9)、(10.9±1.9). After each time point co-mpared with preoperative improved significa ntl-y(p<0.05).On postoperative nerve functio-nat each time point Frankel classificati on statistical analysis,were obviously improved com-pared with preoperative, differe nce h-ad statistical significance(p<0.05).Patients with postoperative imaging studies sugge-st all bone graft fusion,without spinal instability,no broken rod and screw brea kage, n-o loosening,no recurrence and fistula formation.Conclusion:One-stage posterior debridement and bone graft fusion combined with pedicle internal fixation on the basis of conservative drug therapy of the Brucellar spondylitis,can effectively remove lesions,relieve patients’ pain of the lumbosacral and spi-nal cord,nerve compression symptoms,providing the immediate stability of the spine,improve bone graft fusion rate,reduce the patients postoperative complications,for pati-ents with early rehabilitation and return to normal life and work. Key word:Brucellar spondylitis;thoracic vertebrae;lumbar vertebrae;debridement and...