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Imageology in staging and treatment efficacy of transforaminal lumbar interbody debridement and fusion for Brucella spondylitis in lumbar spine

Yongfeng Wang, Bin Zhao, Jie Yuan, Yibo Zhao, Xiangdong Lu, Xinyuan Wei, Anmin Jin

Objective: It was aimed to investigate the application of different imaging methodologies in the grading of lumbar Brucella spondylitis, and to evaluate the value of Transforaminal Lumbar Intervertebral Body Debridement and Fusion (TLIDF) in the treatment.

Methods: 22 patients who had undergone lumbar surgery for Brucella spondylitis were recruited in this study. Erythrocyte Sedimentation Rate (ESR), C-reactive Protein (CRP), Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) were monitored before and after the surgery, and all patients were followed up after discharge to assess the treatment efficacy.

Results: 72.8% of the patients had middle stage Brucella spondylitis, with 22.7% and 4.5% of the patients fell into early and late stage, respectively. 20 out of 22 patients received TLIDF surgery. No relapse or complications were observed during follow-up in all patients. Compared with their presurgery levels, ESR and CRP decreased significantly in these patients after the surgery. Besides, postsurgery VAS and ODI scores also had a significantly improvement compared with the values before surgery (all p<0.05).

Conclusion: Lumbar Brucella spondylitis had different characteristics on image examinations at different stages of the disease. TLIDF was an effective surgical approach to eliminate symptoms and processed long-term clinical efficacy.