| Objective:To explore the diagnostic value of laboratory examination and imaging examination of suppurative spondylitis by comparing the clinical general data,laboratory examination and imaging examination of suppurative spondylitis with spinal tuberculosis and spinal brucellosis infection.to provide ideas for early diagnosis and treatment intervention.Methods:The patients with spinal infection diagnosed by pathology or etiology who first occurred in our hospital from 2010.1 to 2018.12 were studied retrospectively.The general conditions(age,complication,sex and body temperature at admission),laboratory results(WBC,NEU%,CRP,PCT,SAA,ESR)and imaging findings(X-ray,CT and MRI findings)were collected.The clinical data,positive rate,sensitivity and specificity of imaging data of the three groups were analyzed and compared,and the differences among the three groups were compared.Draw the ROC curve of each index for the diagnosis of suppurative spondylitis,compare the area under the ROC curve,and analyze the diagnostic ability of each index for suppurative spondylitis.The predictability of each index was evaluated by Logistic regression analysis,and the prediction model was constructed.Results:A total of 158 patients were included,including 31 cases of suppurative spondylitis with an average age of 59.10±12.01 years,107 cases of spinal tuberculosis with an average age of 47.10±16.22 years,and 20 cases of spinal brucellosis infection with an average age of 52.05±7.37 years.The most common pathogen of suppurative spondylitis was Staphylococcus aureus followed by Escherichia coli.In laboratory examination,the positive rates and average values of WBC,NEU%,CRP,PCT,SAA and ESR in suppurative spondylitis group were higher than those in spinal tuberculosis group and brucellosis group.In the imaging examination,there were significant differences in stenosis of intervertebral space,destruction of intervertebral disc,change of vertebral body height,type of bone destruction and enhanced MRI abscess.Logitstic regression analysis of the above results showed that there was a correlation between age,Charlson score,body temperature and suppurative spondylitis.In laboratory examination,WBC,HGB,CRP,SAA,ESR were related to suppurative spondylitis.In X-ray and CT findings,there was a correlation between the changes of vertebral height,intervertebral space,paraspinal soft tissue calcification and suppurative spondylitis.In the MRI findings,there were correlations among the changes of intervertebral space,the extent of abscess,the degree of vertebral destruction and enhanced MRI.Based on the above results,this study assessed the risk factors of suppurative spondylitis through 10 major items,and proposed a scoring system.The average scores of suppurative spondylitis group,spinal tuberculosis group and spinal brucellosis infection group were 28.42±5.14,12.75 13.61 and 20.33 ±3.70,respectively.The AUC of internal verification of the system was 0.89,the threshold was 22.5,and the diagnostic sensitivity was 89.5%.The specificity is 95.6%.The sensitivity of external model diagnosis is 75.0%and the specificity is 92.9%.Conclusion:Combined with the body temperature and complications of the patients,the WBC,NEU%,HGB,CRP,PCT,SAA,ESR,imaging examination of vertebral bone destruction type,vertebral body breakage degree,intervertebral space stenosis degree,intervertebral disc destruction degree and paraspinal lesions in laboratory examination are of great significance in the diagnosis and differential diagnosis of primary spinal infection.This study puts forward a scoring system for the diagnosis of suppurative spondylitis in primary spinal infection for the first time,which has potential guiding value in the diagnosis of suppurative spondylitis and provides some reference for clinical work. |
