Clinical Features And Surgical Strategies Of Brucella Spondylitis

Objective: To explore the clinical features and surgical strategies of Brucellar spondylitis(BS).Methods: A retrospective analysis of the clinical data of 95 patients with brucellosis spondylitis who underwent surgical treatment in our hospital from January 2013 to September 2019.Anterior Cervical Discectomy and Fusion(ACDF),Transforaminal Lumbar Interbody and Fusion(TLIF)lesion removal,discectomy,bone graft fusion and internal fixation were performed on the cervical spine.Among them,there were 73 males(76.8%)and 22 females(23.2%),aged from 26 to 77 years,with an average of(52.82±1.19)years old.There were 7 cases of cervical spine(7.3%),2 cases of thoracic spine(2.2%),and 86 cases(90.5%)of lumbar and sacral spine.There were 73cases(76.8%)of single segment,14 cases(14.7%)of continuous multi-stage,and 8 cases(8.4%)of skip multi-stage.Collect and analyze medical records,imaging examinations,and laboratory examination data.According to the preoperative and postoperative visual analogue scale(Visual Analogue Scale,VAS),the Japanese Orthopedic Association Scores(Japanese Orthopedic Association Scores)to evaluate the effect of surgery.Record the erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),clinical symptoms and complications before and after the operation.Results: All 95 patients in this group had SAT ≥ 1:160,anterior ACDF on the cervical spine,and posterior TLIF on the thoracolumbar sacral spine.All of them successfully completed the operation without intraoperative complications.ESR and CRP were recovered within 3 months of follow-up Normal,the back pain of all patients was significantly relieved at the last follow-up.The scores of VAS,cervical spine JOA and lumbar spine JOA were significantly improved before discharge and at the last follow-up(P<0.05).Only one case of internal fixation failed due to deep infection,and eventually all patients were cured.Conclusion: Based on the study of the clinical characteristics of BS patients,for patients with intractable pain and progressive neurological dysfunction,ACDF on the cervical spine and TLIF on the thoracic,lumbar,and sacral spine are safe and reliable.