CAO CHEN1, CHUNHUI WANG2, YUANZE GAO1, YONGJUN DU1, HUA LIU1
1Department of Orthopedics, The 474 Hospital of PLA, urumqi, Xinjiang 830013, China - 2Department of Orthopedics, Shihezi People’s Hospital, Shihezi, Xinjiang 832002, China
Objective: discuss clinical feature and treatment strategy of lumbar brucellosis to improve the diagnosis and treatment of this disease.
Methods: retrospective analysis on clinical features, signs and auxiliary examination results of 35 patients with lumbar bru- cellosis admitted to our department between January, 2012 and August, 2015 was performed, through visual analogue pain scale (VAS), spine Japanese Orthopaedic Association (JOA) Score and X-ray films and MRI imaging observation after 8 expectant treatments and 27 operative treatments, the clinical effect of patients was assessed.
Result: • 35 patients all had contact history of flocks and herds, medical history of significant fever with night sweat and repeated lumbago, among which, 18 patients had medical history of significant joint pain of four limbs. • Imaging examination showed the lesions of all patients were distributed in lumbar vertebra and sacral vertebra, bone destruction was mild, which are common in moth-eaten destruction and hyperostosis osteosclerosis around the diseased vertebra, some patients had significant stenosis of intervertebral space and formation of small amount of abscess around diseased vertebra. • Laboratory examination showed >1:200 in brucella agglutination test, RBPT showed positive, erythrocyte sedimentation rate was increased basically, and white blood cell examination showed normal. • The symptoms of all patients were significantly improved after treatment, the effect was satisfied, average VAS score was 8.6 before treatment and 1.7 in the latest follow-up after treatment, average spine function JOA score was 7.4 before treatment and 15.2 in the latest follow-up after treatment.
Conclusion: lumbar brucellosis has the distinctive imaging features and epidemiological characteristics, the diagnosis rate can be increased through contact history, clinical feature, laboratory examination and imaging examination in early stage and the satisfied effect can be obtained by using appropriate treatment method.
lumbar vertebra, bacterium burger, focal clearance, bone graft fusion