TITLE:
The Senile Brucellosis Spondylitis Clinical Diagnosis and Treatment on as Evaluation Were Retrospectively Analyzed
AUTHORS:
Yao Yao, Xinming Yang
KEYWORDS:
Brucelliasis, Spondylitis, Diagnosis, Treatment Strategies, Clinical Evaluation
JOURNAL NAME:
Surgical Science,
Vol.9 No.8,
August
24,
2018
ABSTRACT: Objective: To explore senile brucellosis spondylitis clinical features and diagnostic criteria, in order to improve the diagnosis rate and evaluate the clinical effects of treatment strategies. Methods: From January 2002 to August 2015, 62 patients with Brucella-associated spondylitis were treated with comprehensive diagnosis based on epidemiological history, clinical manifestations, imaging findings, laboratory tests, and local biopsy. The positive rate of red plate agglutination test (RBPT) was 45.1%, the positive rate of serum tube agglutination test (SAT) was 51.6%, and the positive rate of brucellosis anti-human immunoglobulin test (Coomb’s) was 100%. All patients underwent X-ray, CT and MRI examinations. The positive rate of blood culture in pathogenic examination was 16.1%, and the positive rate of bone marrow culture was 38.5%. The positive rate of inflammatory granuloma or abscess in the lesion sampling culture was 73.6%. All patients underwent standardized drug therapy and hyperbaric oxygen adjuvant therapy. Among them, 38 patients with neurological impairment were treated with one-stage debridement and posterior pedicle screw fixation on the basis of drug therapy. The paraspinal abscess and the diseased in-tervertebral space tissue were taken for pathological examination during the operation. One week, two weeks, one month, three months, six months and 12 months after treatment, the patients were evaluated and followed up at the monitoring sites. The evaluation indicators were pain scores, activity of daily living (ADL), imaging findings, and laboratory tests. The SPSS15.0 statistical package was used for analysis. Results: All patients were confirmed by the above-mentioned comprehensive examination after admission. 24 patients (38.71%) were treated with standard drug therapy (group A), no adverse drug reactions and abnormal liver and kidney function; the remaining 38 patients (61.29%) were combined with varying degrees of neurological impairment, and surgical treatment was performed after 2 to 4 weeks of drug therapy without improvement (group B). The pain scores showed that there was a statistically significant difference between the two groups at the same time point (P Conclusion: The senile Brucellosis spondylitis has a characteristic performance. The de-velopment of diagnostic criteria can help to improve the diagnostic rate. Standardized drug treatment has a good cure rate. The implementation of surgery has obvious advantages whether it is to relieve pain, stabilize the spine, restore nerve function, or recover early.