Department of Spine Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese PLA, Lanzhou, Gansu, China.
Department of Spine Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese PLA, Lanzhou, Gansu, China.
World Neurosurg. 2020 Jul;139:608-613. doi: 10.1016/j.wneu.2020.03.209. Epub 2020 Apr 13.
Brucellosis is an endemic disease. Brucellar spondylitis is mainly manifested as a unifocal lesion, but noncontiguous multifocal brucellar spondylitis is more rare.
Herein, we report 3 patients with noncontiguous multifocal involvement of brucellar spondylitis who are over 51 years of age. The diagnosis was established by using magnetic resonance imaging (MRI) and positive brucellar agglutination test. All patients were cured with antibrucellosis chemotherapy and surgery. For patients with a high degree of suspicion of noncontiguous multifocal brucellar spondylitis, especially elderly patients, screening with the use of serologic test for brucellosis and whole spine MRI is crucial to reduce the rate of misdiagnosis and missed diagnosis.
Clinicians should raise awareness of noncontiguous multifocal brucellar spondylitis. The Wright agglutination test and whole spine MRI are the key methods to reduce misdiagnosis and missed diagnosis of noncontiguous multifocal brucellar spondylitis. Drug therapy for brucellar spondylitis is the basis, and surgical treatment is complementary therapy. The use of alternative chemotherapy and surgery for noncontiguous multifocal brucellar spondylitis is also safe and effective.
布鲁氏菌病是一种地方性疾病。布鲁氏杆菌性脊柱炎主要表现为单病灶病变，但非连续多灶性布鲁氏杆菌性脊柱炎更为罕见。
本研究报告了 3 例年龄均超过 51 岁的非连续多灶性布鲁氏杆菌性脊柱炎患者。通过磁共振成像（MRI）和阳性布氏凝集试验诊断为该病。所有患者均通过抗布鲁氏菌化疗和手术治愈。对于高度怀疑非连续多灶性布鲁氏杆菌性脊柱炎的患者，特别是老年患者，使用布氏菌血清学试验和全脊柱 MRI 筛查至关重要，可降低误诊和漏诊的发生率。
临床医生应提高对非连续多灶性布鲁氏杆菌性脊柱炎的认识。虎红平板凝集试验和全脊柱 MRI 是降低非连续多灶性布鲁氏杆菌性脊柱炎误诊和漏诊的关键方法。布鲁氏杆菌性脊柱炎的药物治疗是基础，手术治疗是补充治疗。对于非连续多灶性布鲁氏杆菌性脊柱炎，替代化疗和手术也是安全有效的。
