颈椎布鲁杆菌病性脊椎炎的早期诊断与治疗

Early diagnosis and therapy of cervical brucellar spondylitis

目的探讨颈椎布鲁杆菌病的早期诊断与鉴别诊断及手术治疗的疗效。方法回顾性分析2000年1月～2012年6月本院收治的15例颈椎布鲁杆菌病性脊椎炎患者,男11例,女4例;年龄48～78岁,平均54岁。病程6～21个月,平均10个月。其中3例合并腰椎病变;6例合并不同程度神经功能损伤,采用一期颈前路病灶清除及植骨融合内固定术。行手术治疗的患者比较手术前后日本骨科学会(Japanese Orthopaedic Association,JOA)评分,评价预后及植骨融合情况。结果所有患者均获得随访,患者术后JOA评分较术前提高,差异有统计学意义(P<0.05)。无复发及严重并发症发生,内固定可靠,植骨融合良好。结论颈椎布鲁杆菌病需早期发现早期治疗,如有骨质破坏、神经功能损害应手术治疗。

Objective To investigate the efficacy of early diagnosis and differential diagnosis, surgical treatment of cervical brucellosis. Methods A total of 15 cases （11 males and 4 females） of cervical brucellosis spondylitis patients aged 48 to 78 years （mean 54 years） treated from January 2000 to June 2012 were retrospectively analyzed. The durations were 6 21 months （mean 10 months）. Of the cervical brucellosis spondylitis patients, 3 patients with lumbar diseases underwent medication and 6 patients with varying degrees of neurological dysfunction were treated with anterior debridement, bone fusion and internal fixation. Compare the Japanese Orthopaedic Association （JOA） scores before and after the surgery for prognosis and prediction of interbody fusion. Results All patients were followed up. There was increase in the postoperative JOA score compared with the preoperative JOA score. The difference was statistically significant （P〈0.05）. No recurrence and serious complications happened. The internal fixation and bone grafting fusion were good and reliable. Conclusion Cervical brucellosis should be diagnosed and treated early. A surgery is required when bone destruction or neurological impairment shows up.