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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
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A proposed management classification for spinal brucellosis from India
Naveen Jeyaraman1, Madhan Jeyaraman2, Arulkumar Nallakumarasamy3
1Department of Orthopaedics, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth, Chengalpet, 603108, Tamil Nadu, India.
Travel Medicine and Infectious Disease
|July 1, 2023
Summary
Spinal brucellosis management requires a high index of suspicion and comprehensive assessment. A novel classification aids in guiding treatment decisions for osteoarticular brucellosis, leading to improved outcomes.
Area of Science:
- Infectious Diseases
- Orthopaedic Surgery
- Rheumatology
Background:
- Osteoarticular brucellosis presents variably, often delaying diagnosis due to non-specific symptoms.
- Spinal brucellosis is increasingly reported, yet systematic management guidelines are lacking.
Purpose of the Study:
- To present a novel classification system for the management of spinal brucellosis.
- To evaluate the efficacy of a structured approach to treating spinal brucellosis.
Main Methods:
- A prospective observational study of 25 spinal brucellosis patients.
- Patients were classified, managed with antibiotics (10-12 weeks), and surgical intervention if necessary.
- Clinical, serological, and radiological assessments were performed, with follow-up for disease clearance.
Main Results:
- Statistically significant improvement in inflammatory markers (ESR, CRP) and Brucella titers within six months.
- Radiological outcomes also showed significant improvement.
- Mean treatment duration was 11.42 weeks, with a mean follow-up of 14.42 months.
Conclusions:
- A high index of suspicion in endemic areas is crucial for early diagnosis.
- Comprehensive management involves clinical, serological, and radiological assessment, alongside tailored medical/surgical treatment and regular follow-up.
- The proposed classification aids in successful spinal brucellosis management.
