Analysis Of The Curative Effect Of Internal Fixation Combined With Individualized Drug Treatment For The Limited Lesions Of Spondylitis Of Brucellosis

Objective: To evaluate the clinical effect of limited focus debridement and posterior internal fixation combined with individualized medication in patients with spondylitis due to brucellosis Methods: A total of 44 patients with brucellous spondylitis treated in the Department of Orthopaedics,the First Affiliated Hospital of Hebei North University from June 2014 to January 2019 were selected and treated with internal fixation combined with personalized medicine after limited lesion removal.The average follow-up was 12 Months.Collect and sort out the visual analogue scale(VAS)of pain before surgery and at3,6,and 12 months after surgery to determine whether the patient’s preoperative spinal lesion area or lower extremity radioactive pain symptoms have more after surgery than before surgery Improved;CRP,ESR and RBPT to determine whether Brucellosis is active;X-rays to check the position of the internal fixation and internal plants,whether there is looseness or displacement,and whether the implanted bone is fused;the last follow-up was given to the American Spinal Injury Association’s Neurological Function Classification(ASIA Neurologic al Function Classification)to determine whether the patient’s spinal and spinal cord function had improved.Statistical analysis was performed using SPSS 21.0 statistical software.Results:16 patients with neurological symptoms of brucellosis spondylitis,including 6 patients with ASIA neurological grade C before surgery,2 patients with ASIA neurological grade D after surgery,and 4 with E after surgery;Ten patients with ASIA neurological function classification were D before surgery,and ASIA neurological grade improved to E after surgery.The patient’s VAS score before surgery was(6.33 ± 1.33)points,and the VAS scores at the 3rd,6th,and 12 th months after surgery were(2.31 ± 0.81)points,0 points,0 points,and the postoperative time points decreased compared with the preoperative period,the difference was statistically significant(P<0.05).The preoperative C-reactive protein(65.31 ± 4.01)mg / L,and the C-reactive protein values at 3,6,and 12 months after operation were(4.31 ± 0.12)mg/L,(3.05 ± 0.01)mg/L,and(1.33 ± 0.12)mg / L,preoperative erythrocyte sedimentation(54.78 ± 3.12)mm/h,and postoperative erythrocyte sedimentation values at(13.08 ± 1.01)mm / h,(6.21 ± 1.32)mm/h,(2.32 ±0.38)mm / h,and the values of C-reactive protein and erythrocytes edimentation rate decreased after operation compared with before operation,the difference was statistically significant(P<0.05).The X-rays reviewed in all patients at the 6th and 12 th months after operation showed that the internal fixation and the position of the internal plants were good,and the bone graft healed.Conclusion: the treatment of limited focus clearing and posterior internal fixation combined with individualized drug treatment for patients with spondylitis of brucellosis with surgical indications has good postoperative recovery and satisfactory clinical effect.