[Clinical evaluation of one-stage radical debridement combined with posterior pedicle internal fixation for brucellar spondylitis of the thoracic and lumbar vertebrae].

OBJECTIVE

To discuss the surgical treatment method and effectiveness of brucellar spondylitis.

METHODS

Between January 2002 and October 2010, 78 patients underwent one-stage radical debridement and posterior pedicle internal fixation, who were definitely diagnosed as having brucellar spondylitis of the thoracic and lumbar vertebrae. There were 42 males and 36 females, aged 24 to 65 years (mean, 45 years). The disease duration was 8-29 months (mean, 12 months). Two vertebrae were involved in 70 cases and three vertebrae were involved in 8 cases. All of the cases complicated by nerve function damage in different extent before operation. The patients were followed up regularly after operation. The pain score (visual analogue score, VAS), nerve function Frankel classification, effectiveness evaluation, and the blind test evaluation of X-ray and MRI were performed.

RESULTS

All 78 cases were followed up 12 to 30 months (mean, 26 months). No sinus tract and recurrence occurred. The VAS scores were significantly improved at 1 month (2.4 +/- 0.3), 3 months (1.0 +/- 0.2), 6 months (0.5 +/- 0.4), and 12 months (0) when compared with preoperative score (9.2 +/- 0.6) (P < 0.05). The nerve function Frankel classification after operation was significantly improved when compared with preoperative one (P < 0.05); the patients in grade C and grade D had the most obvious improvement. The effectiveness evaluation indicated no aggravated cases. As time went on, the improved and unchanged patients were cured gradually and the improvement rate and the curative rate were 100% and 91.03%, respectively at 12 months after operation. The imaging scores were significantly improved at 1 month (4.11 +/- 0.09), 3 months (4.68 +/- 0.04), 6 months (4.92 +/- 0.08), and 12 months (5) when compared with the preoperative score (0.17 +/- 0.03) (P < 0.05).

CONCLUSION

One-stage radical debridement combined with posterior pedicle internal fixation is an ideal therapeutic method for brucellar spondylitis of the thoracic and lumbar vertebrae, which has obvious superiority in pain relief, the spine stability, the nerve function recovery, and early rehabilitation.