Observation And Analysis Of Curative Effect Of Simple Posterior Approach On Lumbar Brucellar Spondylitis With Abscess

Objective To investigate the clinical effects of simple posterior approach and the imaging significance of surgical strategies for lumbar brucellar spondylitis with abscess.Method The 53 patients diagnosed as lumbar brucellar spondylitis with abscess between May 2008 to May 2016 were enrolled into the study.The imagine examination included X-ray,CT and MRI were performed before operation to confirm the inflammatory infiltration range,abscess site and size and the degree of bone destruction.All cases were divided into 2 groups according to the surgical approach.Thirty-one cases with paravertebral abscess were received single posterior transverse process,focal debridement,pedicle screw fixation as group A.Twenty-two cases with epidural abscess were performed single posterior decompression,focal debridement,pedicle screw fixation and transverse process as group B.The lumbar kyphosis angle(Cobb angle),imaging observation,VAS,ODI and Frankel classification before and after operation between two groups were reviewed and compared to assess the clinical treatment.The comparison between each group included ESR and CRP was evaluated the recovery of spinal inflammation.Results Two groups of operations were successfully completed,incision healed,no infection and sinus formation.During follow-up,all cases had met the standard of solid bone fusion without any internal instrument failure.VAS,ODI,ESR and CRP before and after surgery had significant difference in each group(P<0.05)while the difference between two groups had no statistical signification(P>0.05)in each time.The difference of Cobb angle in any group two weeks after the operation had statistical signification(P<0.05)but had no statistical signification one year after operation(P>0.05).At the final Frankel grade: D grade three cases,E grade fifty cases.The result of RBPT and SAT had turned(-)after one year among all cases.Imaging scores gradually increased over time.Conclusion Based on preoperative imaging evaluation and reasonable choice of surgical approach,simple posterior treatment can effectively relieve pain and improve the ability of autonomy in daily life,cure spinal inflammation as well as obtain satisfactory clinical efficacy for lumbar brucellar spondylitis with abscess.