Diagnosis and surgical treatment of the Brucellar spondylitis
10.3760/cma.j.issn.0253-2352.2012.04.006
- VernacularTitle:布鲁杆菌病性脊柱炎的诊断与手术治疗
- Author:
Mamat MAIRDAN
;
Juan TIAN
;
Weibin SHENG
;
Xinfeng ZHENG
;
Hailong GUO
;
Mamat PULAT
- Publication Type:Journal Article
- Keywords:
Brucellosis;
Spine;
Infection;
Diagnosis;
Spinal fusion
- From:
Chinese Journal of Orthopaedics
2012;32(4):323-330
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical,laboratory,imaging characteristics and surgical outcomes of Brucellar spondylitis.Methods The clinical,laboratory,imaging characteristics and surgical outcomes of 27 patients with Brucella spondylitis were analyzed in our department from September 2000 to December 2010.There were 18 males and 9 females,aged from 23 to 57 years(average,32.8 years ).There were 3 cases in cervical vertebra,8 cases in thoracolumbar vertebra,16 cases in lumbosacral vertebra respectively.Before admission,17 patients were misdiagnosed as tuberculosis,2 ones were as postoperative change of lumbar disc herniation.Eight patients underwent posterior debridement,autologous bone grafting and instrumentation,19 cases were treated with anterior debridement,autologous bone grafting and instrumentation.Streptomycin was placed in localized lesions for 24 patients,except for 3 cases whose streptomycin skin test positive.External fixation brace were used for 4 to 6 weeks,oral medication was used for a half month to 3 months.Clinical evaluation included clinical cure rate,pain visual analog scale (VAS) and the fusion rate.Results All of 27 patients were followed up for an average of 19.7 months (range,6 to 48 months).According to evaluation standard for Brucella spondylitis,24 patients were cured,3 patients got improvement.Three patients underwent the second operation owing to wound infection and sinus formation.Conclusion The pain of spine with intermittent fever,the imaging features as well as positive serum agglutination test can confirm the diagnosis of Brucellar spondylitis.Operation should be considered in patients with persistent pain and neurologic disorders as well as systemic symptoms.Instrumentation is effective and safe in the treatment of patients with spinal brucellosis following debridement,autogenous bone grafting,combined with antibiotic therapy.
