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Noncontiguous dual segment thoracic brucellosis with neurological deficit
Mehmet Tezer1, Cagatay Ozturk, Mehmet Aydogan
1Istanbul Spine Center, Florence Nightingale Hospital, Abide-I Hürriyet Caddesi No: 290 80220, Sişli, Istanbul, Turkey.
Summary
This study highlights a rare case of thoracic brucellosis affecting multiple spinal levels. Aggressive surgical intervention and medical treatment led to a complete recovery, demonstrating effective management of spinal brucellosis.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Neurosurgery
Background:
- Brucellosis commonly affects the musculoskeletal system, with bony involvement reported in 2-70% of cases.
- Spinal brucellosis typically localizes to the sacroiliac region; thoracic involvement is infrequent.
- Noncontiguous multilevel thoracic brucellosis with spinal cord compression is exceptionally rare.
Observation:
- A case report detailing a patient with noncontiguous multilevel thoracic brucellosis causing spinal cord compression.
- The patient required extensive surgical intervention, including posterior decompression, fusion, stabilization, and anterior corpectomy with mesh cage fusion.
- The case highlights the challenges of diagnosing and managing rare presentations of brucellosis.
Findings:
- The patient achieved a complete neurological recovery.
- At a 2-year follow-up, clinical, radiological, and laboratory assessments showed no signs of recurrent infection.
- Aggressive surgical debridement and stabilization were key to successful treatment.
Implications:
- Early and aggressive surgical debridement combined with medical therapy is crucial for eradicating spinal brucellosis.
- This approach is particularly vital for elderly and immunocompromised patients who are at higher risk.
- The findings support a multidisciplinary approach for managing complex spinal infections.