Differential diagnosis and treatment of brucella spondylitis and spinal tuberculosis / 中华骨科杂志

ABSTRACT

Brucella spondylitis and spinal tuberculosis are two common specific infectious diseases in spine surgery. They have many similar manifestations in clinical manifestations and imaging features. Clinically, there are symptoms such as pain, fever, hyperhidrosis, and anorexia. When inflammation involves the intervertebral space, intervertebral disc, or epidural abscess, it can cause nerve compression, resulting in pain, numbness, sensory disturbances, and decreased muscle strength in the corresponding innervated areas. And even in severe cases it can cause paralysis. The early imaging of both showed bone destruction of the involved vertebral body, narrowing or disappearance of the intervertebral space, and the formation of paravertebral abscesses. Therefore, it is very easy to cause misdiagnosis. This article compares and summarizes the diagnosis of brucellosis spondylitis and spinal tuberculosis from four aspects clinical manifestations, imaging characteristics, and laboratory examinations and histopathological examinations. Based on the above, the treatment principles and surgical indications of the two diseases were summarized and discussed from the aspects of drug treatment and surgical treatment, with an aim to further improve the clinical diagnosis and treatment of the two diseases.