TITLE:
Clinical Study on Treatment of Type II/III Lumbar Brucellar Spondylitis by Unilateral Biportal Endoscopy
AUTHORS:
Xinming Yang, Yongli Jia, Fei Liu, Zhe Zhang, Peinan Zhang
KEYWORDS:
Brucellar Spondylitis, Minimally Invasive Surgery, Unilateral Biportal Endoscopy, Clinical Efficacy
JOURNAL NAME:
Surgical Science,
Vol.14 No.5,
May
22,
2023
ABSTRACT: Objective: Explore the feasibility and clinical efficacy of
using unilateral biportal endoscopy for the treatment of Type II/III lumbar
brucellar spondylitis. Methods: A retrospective study of the clinical data of 20
patients with Type II/III lumbar brucellar spondylitis admitted
to the First Affiliated Hospital of Hebei North University from January 2020 to
May 2022, including 15 males and 5 females, aged 41 - 60
years old, average age (48.11 ± 7.28)
years old. After admission, the patient can isolate brucella through
metagenomic Next-Generation
Sequencing (mNGS), meeting the tertiary diagnostic criteria. Preoperative conventional drug treatment, unilateral biportal endoscopic minimally
invasive surgery was performed when nutrition was improved, perioperative control
of various indexes was stable, and erythrocyte sedimentation was declining. It was completed under an endoscope. The lesion was cleared, spinal nerve compression was relieved, interbody fusion was
performed, and the spine was fixed by a percutaneous
pedicle screw. Erythrocyte Sedimentation Rate (ESR),
C-Reactive Protein (CRP), Visual Analogue Scale (VAS), Japanese Orthopedic Association (JOA) score and
Oswestry Disability Index (ODI) were analyzed at 1 month, 3 months, 6
months and the last follow-up. At the final follow-up of all patients, the clinical
efficacy criteria and the Bridwell grading criteria were used to
evaluate the recovery and intervertebral bone graft fusion, respectively. Results: All patients’ lower back and leg pain was relieved the
next day after surgery. At a follow-up of one month after surgery, both systemic and local symptoms significantly
improved. At the last follow-up, clinical
symptoms disappeared and there was no tenderness or percussion pain in the
local area. With the passage of time, 1 month, 3 months, 6 months after the operation, and the last follow-up are all evaluation
indicators compared with those before the operation. No matter VAS, JOA, ODI score, or ESR, CRP is significantly improved compared with preoperative (P All 20
cases in this group reached the BS clinical cure standard, and the excellent
rate of intervertebral bone graft fusion was 95%. Conclusion: On the basis of