颈椎布鲁杆菌性脊柱炎的临床特点和外科手术治疗

Study on clinical features and efficacy of surgical treatment for brucellar cervical spindylitis

目的探讨临床罕见的颈椎布鲁杆菌性脊柱炎的临床特点、外科手术治疗效果。方法回顾性分析2007年2月至2017年3月采用颈前路病灶清除植骨内固定外科手术治疗15例布鲁杆菌性脊柱炎患者的临床疗效、影像学特点、实验室检查及JOA评分改善情况。结果平均手术时间60.7±5.4 min,术中平均出血量350.8±54.3 ml。无手术并发症。全部病例得到随访3~72个月,平均36个月。15例患者临床效果良好,临床症状均消失,术后一年所有患者病患处均骨性愈合,红细胞沉降率和C反应蛋白水平均逐渐恢复正常,术后3个月JOA评分改善率为76%。结论颈椎布鲁杆菌性脊柱炎外科手术治疗可以取得满意的效果。

Objective To explore the efficacy of surgical treatment for brucellar cervical spondylitis,which is very rarely seen in cilinical practce.Methods The clinical data of 15 patients with brucellar cervical spondylitis undergoing surgical treatment by procedures of anterior debridement and graft internal fixation during February 2007 to March 2017 were retrospectively reviewed,their clinical symptoms,physical examinations,radiological features,laboratory findings as well as JOA scores were reviewed during the course.Results The average operating time was60.7 ± 5.4 min,and the average volume of intraoperative bleeding was 350.8 ± 54.3 ml.There was no operative complication occurred.All these cases had been followed up for 3 ~ 72 months,with an average of 36 months.Among them,15 patients were treated with good clinical effect,clinical symptoms disappeared,all these patients were healed in 1 year after the treatment,the level of C reactive protein and erythrocyte sedimentation rate were gradually returned to normal in 3 months after the surgery,and the improvement rate of JOA scores was 76% in 3 months after the treatment.Conclusion The surgical treatment by anterior debridement and the procedure of graft internal fixation for patients with brucellar cervical spondylitis is safe and effective.