Comparison of brucellar and tuberculous spondylodiscitis patients: results of the multicenter “Backbone-1 Study”

Erdem, Hakan; Elaldı, Nazif; Batırel, Ayşe; Aliyu, Sani H; Şengöz, Gönül; Pehlivanoğlu, Filiz; Ramosaço, Ergys; Gülsün, Serda; Tekin, Recep; Mete, Bilgül; Balkan, İ̇lker İnanç; Sevgi, Dilek Yıldız; Giannitsioti, Efthymia; Fragou, A.; Kaya, Selçuk; Çetin, Birsen; Öktenoğlu, Tunç; Dogan-Celik, Aygul; Karaca, Banu; Horasan, Elif Şahin; Ulug, Mehmet; İnan, Asuman; Kaya, Şafak; Arslanalp, Esra; Ates-Guler, Selma; Willke, Ayşe; Şenol, Şebnem; İnan, Dilara; Güçlü, Ertuğrul; Tuncer-Ertem, Gunay; Meriç-Koç, Meliha; Taşbakan, Meltem; Şenbayrak, Seniha; Çiçek-Şentürk, Gönül; Sırmatel, Fatma; Öcal, Gülfem Akengin; Kocagöz, Sesin; Kusoglu, Hulya; Güven, Tümer; Baran, Ali İrfan; Dede, Behiye; Yılmaz-Karadağ, Fatma; Köse, Şükran; Yılmaz, Hava; Aslan, Gönül; ALGallad, D. Ashraf; Cesur, Salih; El-Sokkary, Rehab H.; Bekiroğlu, Nural; Vahaboğlu, Haluk

doi:10.1016/j.spinee.2015.09.024

Cited by 40 publications

(30 citation statements)

References 19 publications

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“…The pathological process is very similar to tuberculostic infection, which is the “great imitator” of this disease. However, spinal brucellosis is relatively less destructive than spinal tuberculosis, and usually has good response to the antibiotic treatment [13]. Generally, most of the patients with spinal brucellosis can be treated nonoperatively.…”

Section: Discussionmentioning

confidence: 99%

Single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral brucellosis

Abulizi

Muheremu

et al. 2017

BMC Surg

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BackgroundSpinal brucellosis is a less commonly reported infectious spinal pathology. There are few reports regarding the surgical treatment of spinal brucellosis in existing literature. This retrospective study was conducted to determine the effectiveness of single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral spinal brucellosis.MethodsFrom February 2012 to April 2015, 32 consecutive patients (19 males and 13 females, mean age 53.7 ± 8.7) with lumbosacral brucellosis treated by transforaminal decompression, debridement, interbody fusion, and posterior instrumentation were enrolled. Medical records, imaging studies, laboratory data were collected and summarized. Surgical outcomes were evaluated based on visual analogue scale (VAS), Oswestry Disability Index (ODI) and Japanese Orthopaedic Association (JOA) scale. The changes in C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), clinical symptoms and complications were investigated. Graft fusion was evaluated using Bridwell grading criteria.ResultsThe mean follow-up period was 24.9 ± 8.2 months. Back pain and radiating leg pain was relieved significantly in all patients after operation. No implant failures were observed in any patients. Wound infection was observed in two patients and sinus formation was observed in one patient. Solid bony fusion was achieved in 30 patients and the fusion rate was 93.8%. The levels of ESR and CRP were returned to normal by the end of three months’ follow-up. VAS and ODI scores were significantly improved (P < 0.05). According to JOA score, surgical improvement was excellent in 22 cases (68.8%), good in 9 cases (28.1%), moderate in 1 case (3.1%) at the last follow-up.ConclusionsSingle-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation is an effective and safe approach for lumbosacral brucellosis.

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Section: Discussionmentioning

confidence: 99%

Single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral brucellosis

Abulizi

Muheremu

et al. 2017

BMC Surg

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“…Similarly, a recent study reported an abscess formation rate of 39.5% and paravertebral involvement rate of 21.4% [31]. In another study, abscess formation and paravertebral involvement were very high, at rates of 81% and 58.3%, respectively [29].…”

Section: Discussionmentioning

confidence: 73%

Spondylodiscitis: a common complication of brucellosis

Kutlu

Tuzun

et al. 2018

J Infect Dev Ctries

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Introduction: Brucellar spondylodiscitis is a frequent and serious complication of brucellosis. The aim of this study is to describe the brucellosis patients with spondylodiscitis and the predictive factors related to spondylodiscitis in brucellosis. Methodology: Laboratory-confirmed brucellosis patients from a low-to medium-endemic region were enrolled in the study and distributed into two groups. Group I consisted of patients with spondylodiscitis and Group II patients had no complications. Both groups were compared for predictive factors of spondylodiscitis. Results: A total of 219 patients with active brucellosis were included in the study. We determined at least one complication in 91 (41.6%) patients. The most frequent complication was spondylodiscitis [n = 59 patients (26.9 %)]. In univariate analysis, age, time from symptom onset to diagnosis, presence of low back pain, increased levels of erythrocyte sedimentation rate, and alkaline phosphatases were the most significant predictive factors for spondylodiscitis among brucellosis cases. Presence of headache and thrombocytopenia were less frequent in patients with spondylodiscitis when compared to patients without complications (p = 0.024, p = 0.006 respectively). In multivariate analysis, old age (odds ratio [OR] 1,063; 95% confidence interval [CI] 1.026-1.101; p < 0.001), prolonged time between symptoms onset before diagnosis (OR 1.008; 95% CI 1.001-1.016; p = 0.031), and presence of low back pain (OR 12.886;; p < 0.001) were indepedently associated with an increased risk of spondylodiscitis. Conclusions: Spondylodiscitis is the most frequent complication of systemic brucellosis. Patients with low back pain, older age, and longer duration of symptoms should be considered as candidates of potential spondylodiscitis in brucellosis.

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“…The most frequently affected area is the lumbosacral region. Sacroiliitis is observed more frequently in younger patients, whereas spondilitis is more frequent in older patients [4,5,9].…”

Section: Discussionmentioning

confidence: 96%

“…One of the most frequent complications of brucellosis is osteoarticular involvement with musculoskeletal symptoms leading to rheumatological manifestations. The most common osteoarticular tables are sacroiliitis, spondylitis, and peripheral arthritis, as well as vertebral osteomyelitis [1,[4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Can imaging modalities be used as follow-up criteria after brucellar sacroiliitis treatment?

Bilgeturk

Gül

Karakaş

et al. 2017

J Infect Dev Ctries

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Introduction: This study aimed to identify a follow-up modality that can be used to evaluate therapeutic responses in patients receiving treatment for brucellar sacroillitis and to determine whether antibiotherapy can be stopped. Methodology: A total of 32 patients with sacroiliac joint involvement demonstrated via magnetic resonance imaging or bone scintigraphy were followed up and treated. Patients received 200 mg/day of doxycycline and 600-900 mg/day of rifampicin for 3-21 months, and 1 g/day of streptomycin for 21 days. Results: The mean age of the 32 patients involved was 21.81 ± 4.09. In total, 10/32 patients did not complete therapy, and the remaining 22 patients received combination antibiotic treatment for a mean of 8.95 ± 4.34 months. Of the 22 patients, 15 underwent MRI, and 7 of them did not consent to MRI. Similarly, 17 patients were followed up by bone scintigraphy, and 5 patients did not have scintigraphy results. In 9/17 patients followed up with bone scintigraphy, sacroiliitis findings were found to reduce after a mean of 7.44 ± 3.71 months, whereas in 12/15 patients on whom MRI was performed, there were no active sacroiliitis findings for a mean of 6.95 ± 2.83 months. Conclusions: While active involvement findings in bone scintigraphy were observed for a longer period in scintigraphy images, active sacroiliitis findings disappeared in a relatively shorter period of time with MRI. Therefore, we have demonstrated that high-resolution MRI is a very sensitive technique compared to scintigraphy.

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Comparison of brucellar and tuberculous spondylodiscitis patients: results of the multicenter “Backbone-1 Study”

Cited by 40 publications

References 19 publications

Single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral brucellosis

Single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral brucellosis

Spondylodiscitis: a common complication of brucellosis

Can imaging modalities be used as follow-up criteria after brucellar sacroiliitis treatment?

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