Abstract:

Objective To explore the clinical value of anterior oblique lumber interbody fusion in the treatment of lumbar Brucellar spondylitis.Methods A retrospective analysis of 20 cases of lumbar Brucellar spondylitis treated by anterior oblique lumber interbody fusion from March 2015 to October 2017 was studied. The clinical symptoms, operative time, bleeding volume, complications, outcome, and bone graft fusion were investigated. The visual analogue score (VAS), white blood cells (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) before and after the operation were also analyzed.Results The operation time of the anterior opera-tion was 40-90 minutes, with an average of (65.00±8.21) min; the amount of bleeding was 200-400 ml, with an average of (290.53±37.25) ml. One case had peritoneal injury during exposure and received intraoperative repair; 1 case had sympathetic nerve injury resulted from lumbar 4/5 operation, 1 case had reoperation for post-operative contralateral nerve root pain, all were cured. The last follow-up VAS score (1.31±0.96; t=29.37, P=0.000), WBC ((4.56±1.02) ×10 ⁹/L; t=12.49, P=0.034), ESR ((25.53±3.56) mm/1h; t=39.93, P=0.000), and CRP ((13.61±7.65) mg/L; t=15.82, P=0.008) were significantly improved compared with the preoperative VAS score (7.43±1.07), WBC ((9.65±2.38)×10 ⁹/L), ESR ((81.22±12.27) mm/1h), and CRP ((59.08+20.39) mg/L). Follow up for 6 to 18 months, no recurrence occurred, and 20 cases were satisfied with bone graft fusion.Conclusion Lumbar interbody fusion with anterior oblique approach is an ideal minimally invasive technique for lumbar Brucellar spondylitis with less trauma, less bleeding, and rapid recovery.

Key words: Brucellosis, Spondylitis, Spinal fusion, Surgical procedures, Minimally invasive, Treatment outcome