Diagnosis and Comprehensive Surgical Treatment of Brucella Spondylitis

Abstract：Objective To investigate the diagnosis and clinical effects of surgical treatment for brucella spondylitis. Methods Based on the evidences from epidemiological history,clinical manifestations,imaging,laboratory and pathology,93 cases of Brucella spondylitis patients were diagnosed and treated in our hospital from January 2008 to January 2013. 22 cases of patients with non-surgical indications were treated with doxycycline,rifampicin and sulfamethoxazole(A group),71 cases(6 cases of cervical spondylitis,65 cases of lumbar spondlylitis)with surgical indications underwent debridement and autograft with internal fixation on the basis of drug therapy. Clinical effects were assessed at 3,6 and 12 months after treatments and u-sing SPSS 15. 0 statistical software for analysis. Results 3-month follow-up rate of 93 cases was 100%,6-month follow-up rate in group A was 8 6 . 3 6%,group B was 9 1 . 5 4%,1 2 - month follow - up rate in group A was 7 7 . 2 7% ,group B was 83. 09%. Last follow-up showed that all patients were in good conditions. There were no adverse drug reactions and liver and kidney dysfunction. No broken nails or broken rods cases. Surgical incisions healed well. Cervical and lumbar spine bone healed without bone graft complications. The cure rates in all groups were gradually improved. Differences were statistically significant ( P﹤0. 05)compared the cure rates at 3,6 and 12 months,but at the same time point,the difference was not statistically signif-icant between two groups(P﹥ 0. 05). Conclusion Brucella spondylitis is easy to make a diagnosis and differential diagnosis based on epidemiological history,clinical manifestations,imaging features and laboratory tests. A long-term,adequate,joint sensitive antibiotics are the most important and most reliable method to prevent recurrence of the disease. The correct threapy according to non-surgical and surgical indications can heal lesions and improve clinical outcomes.