To analyze and explore the safety and efficacy of pedicle screw fixation and short segment internal fixation in the treatment of lumbar brucellosis spondylitis.

A retrospective analysis from March 2009 to May 2015 according to the diagnostic criteria of posterior debridement, intertransverse fusion, disease and treatment of vertebral pedicle screw short segment internal fixation of 20 cases of lumbar brucellar spondylitis patients, male 12 cases, female 8 cases, age 20-66 years old, average 41.3 years old. Segmental lesions (L2-S1 were less than 3 segments). X-ray, CT and MRI examinations were performed before operation to determine the inflammatory infiltration and bone destruction in the diseased segment, vertebral pedicle and vertebral body. Postoperative imaging observation of bone graft fusion and vertebral stability, and before and after the surgery the pain visual analogue scale, Cobb angle, Frankel classification of neurological function and laboratory detection of erythrocyte sedimentation rate, C reactive protein (CRP) evaluation indexes were compared and statistically analyzed.

All the 20 patients were followed up for 24-48 months, with an average of 32 months. The follow-up period showed no recurrence, no incision infection and sinus formation, internal fixation, no loss, breakage and loosening. All patients with symptoms of poisoning and infection of brucellosis spondylitis symptom disappeared, preoperative Frankel grade: C grade 6 cases, D grade 5 cases, 9 cases of grade E, the last follow-up Frankel grade: D grade 2 cases, 18 cases of grade E. Visual analogue scale from preoperative (8.85±1.62) points to one week after operation (3.39±0.95) points at the final follow-up (0.81±0.11) points (F=72.05, P<0.05). Convex Cobb angle before and after operation for an average of 15.31 degrees plus or minus 2.42 degrees, one week after operation for 4.28 degrees plus or minus 2.12 degrees at the end of the follow-up, 4.21 degrees - 1.31 degrees (F=214.85, P<0.05). Erythrocyte sedimentation rate from preoperative (40.25±1.51) mm/h recovered to one week after operation (16.46±5.72) mm/h, at the end of follow-up (8.47±0.62) mm/h (F=184.49, P<0.05). C reactive protein by preoperative (71.11±7.22) mg/L recovered to one week after operation (22.44±4.82) mg/L, at the end of follow-up (5.12±0.73) mg/L (F=265.71, P<0.05). The bone graft fusion time was 6-11 months, with an average of 7.4 months.

Brucellosis lumbar spondylitis under the premise of good indications for surgery, as long as the preoperative imaging information and surgery to determine the correct status of vertebral infection, select the removal of posterior lesion, bone graft, vertebral nail set, short section Segment of the fixed surgical plan for the relief of pain, infection control, relieve nerve compression, stabilize the spine, reduce trauma and promote functional recovery is safe and reliable, and has good clinical results.