The Research On One-stage Anterior Operation For Treatment Of The Brucellar Spondylitis In The Cervical Vertebra

Brucellar spondylitis in the cervical vertebra remains comparatively rare,however, clinical symptoms is often serious for the specificity of positon.The study mainly research on the efficiency and clinical effect of surgery on brucellar spondylitis in the cervical vertebra to provide scientific theoretical basis and clinical experience for scholars at home and abroad.Thirty-two patients with the brucellar spondylitis in the cervical vertebra diagnosed and examined by clinical and laboratory have operation indications,all of the patients were treated by drugs and had no improved symptoms and signs,There was hardly absorbable paravertebral abscess or epidural abscess in the vertebral canal, or destructive intervertebral disc, or inflammatory granulation tissue protruding into the vertebral canal and opressing the spinal cord, cauda eguina or nerve root, or unstable spine by MRI in all the cases. Of which 24 cases were treated by one-stage anterior cervical discectomy debridement, Cage bone fusion and internal fixation and 8 cases were treated by One-stage stage anterior cervical debridement,bone graft with titanium cage and internal fixation. The patients were treated by standard drugs after the operation, assisting hyperbaric oxygen treatment again. Male 21 and female 11, the age of patients ranged from 36 to 62 years old(mean 49.5). Disease course ranged from 3 to 6 months(mean 4.5). There were 2 lesions in the 24 patients,The defect sites were C3-4 in 2 case,C4-5 in 10 case,C5-6 in 9 case,C6-7 in 3 case, there were3 lesions in the 8 patients, the defect sites were C3-5 in 2 case,C4-6 in 5case,C4-6 in 1 case,both were nerve function deficit. All the patient were processed with visual analogue scale( VAS) and Japanese Orthopedic Association(JOA) before the operation and after the operation separately,evaluation of clinical curative effect, X-ray and MRI iconography observation.Thirty-two patients were followed after treatment, the mean follow-up time range from 12 to 36 months. VAS and JOA score before the operation and at the 12 th month after operation separately were( 9.2±0.6) and( 8.0±1.4),( 1.5±0.4) and( 14.5±1.5). Index were changed more significantly(P<0.05),After 12 months postoperatively,all cases were showed signs of bone fusion, all cases were observed fully integrated titanium or cage bone graft between the upper and lower vertebrae at the12 th follow-up. and no recurrence or instrument failure was noted. The good rate after operation were 90.65%、96.88%、100%. Neither X-ray or MRI found relapse at the 3th、6 th、12th month.The method could control the development of pathological changes,relieve pain, reconstruct cervical stability and recover the nerve function to obtain satisfactory short-term effects.