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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
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Differences analysis between spinal tuberculosis and brucella spondylitis with preoperative non-invasive differential
Zhong Ma1,2, Xin Liu1,2, Mingtao Zhang1,2
1Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, 730000, China.
Summary
Differentiating spinal tuberculosis (STB) from Brucella spondylitis (BS) is crucial for accurate diagnosis. Key indicators like root symptoms, necrosis, male gender, decreased A/G ratio, and spinal curvature changes help distinguish these conditions.
Area of Science:
- Infectious Diseases
- Orthopedics
- Radiology
Background:
- Spinal tuberculosis (STB) and Brucella spondylitis (BS) are granulomatous infections of the spine.
- These conditions share similar presentations, leading to frequent misdiagnosis.
- Accurate preoperative differentiation is essential for appropriate treatment.
Purpose of the Study:
- To identify non-invasive indicators for differentiating STB from BS.
- To improve diagnostic accuracy and avoid treatment delays.
Main Methods:
- Retrospective analysis of clinical, laboratory, and imaging data from 89 STB and 66 BS patients.
- Statistical analysis including chi-squared tests, Mann-Whitney U tests, and binary logistic regression.
- Receiver operating characteristic (ROC) curve analysis to evaluate predictive factors.
Main Results:
- Significant differences observed in root symptoms (P=0.024) and necrosis (P=0.045).
- Independent predictors identified: gender (P=0.009), decreased A/G ratio (P=0.003), thoracic vertebra involvement (P<0.001), number of damaged vertebrae (P=0.005), and spinal curvature straightening (P=0.014).
- A predictive model achieved an AUC of 0.854 (0.796-0.911).
Conclusions:
- Root symptoms and necrosis formation are key differentiating features.
- A combination of factors including male gender, decreased A/G ratio, absence of thoracic involvement, fewer than 2.5 damaged vertebrae, and spinal curvature straightening strongly suggests Brucella spondylitis over spinal tuberculosis.
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