The Value Of Laboratory Examination And Imaging Examination In Preoperative Diagnosis Of Brucellosis Spondylitis

Objective To explore the value of laboratory examination and imaging examination in preoperative diagnosis of brucellosis spondylitis.Methods We retrospectively analyzed the laboratory and imaging data of 55 patients with brucellosis spondylitis who underwent spine orthopedic surgery in the general hospital of Ningxia Medical University from December 2013 to December 2015.To analyze the diagnostic value of laboratory examination:Agglutination test of Brucella,CRP,ESR and imaging examination:DR,CT and MRI.Results Fifty-five patients were positive for brucellosis agglutination test,49 cases(89%)increased ESR and 54 cases(98%)increased CRP.There was no significant difference between the two groups(P <0.05).DR showed fewer cases of bone destruction than CT(X2=24.456,P=0.000)and MRI(X2=32.920,P=0.000),and the difference was statistically significant.CT and MRI showed no significant difference in bone destruction ability(X2=2.192,P=0.139).MRI is not sensitive to the development of bone sclerosis,and CT shows more clearly than DR in bone sclerosis(P<0.05).DR is not sensitiveon on paraspinal abscess,spinal epidural abscess and intervertebral disc,but MRI is significantly stronger than CT in this area(P <0.05).There was no significant difference in identifying the three kinds of examination methods in the intervertebral space and ligament calcification(P> 0.05).CT and DR are more sensitive than MRI in bone hyperplasia(P=0.000).Conclusion1、Brucella agglutination test as the most commonly used serum immunological examination method on brucellosis spondylitis can clear the type of inflammatory infection,but the application may be false positive or false negative.CRP and ESR is able to effectively find the body inflammation,but the identification of the causes of spinal infection is still vacant.2、MRI can detect early bone destruction,and tare sensitivehe on disc destruction,paraspinal abscess,epidural abscess and other soft tissue lesions.CT and DR are more sensitiven on bone hyperplasia sclerosis,bone destruction and ligament calcification.Combining with three Imaging examination,we can identify the site of infection and the severity of infection.3、Combining with the patient’s history,symptom,signs,laboratory tests and clear preoperative imaging data,brucellosis spondylitis can be diagnosed more clearly.