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目的探讨布氏杆菌性脊柱炎的影像学特点并分型,以提高该病确诊率并指导治疗方案的选择。方法回顾性分析自2013-01—2016-01诊治的52例布氏杆菌性脊柱炎,经冷凝集试验和影像学检查确诊为布氏杆菌性脊柱炎。采用单纯药物治疗28例,微创介入治疗3例,21例行病灶清除植骨融合内固定术。结果本组52例布氏杆菌性脊柱炎按照影像学特点分型:椎体骨髓炎型9例,椎间盘炎型8例,椎旁脓肿或硬膜外脓肿型5例,混合型30例。49例获得随访16~36个月,平均12个月。疗效根据Alp标准评定:痊愈47例,好转2例。无复发患者。结论布氏杆菌性脊柱炎有特征性影像学表现,在有效药物治疗的前提下可根据不同影像学分型选择微创或开放手术治疗。
Objective To investigate the imaging features and classification of brucellosis spondylitis in order to improve the diagnosis of the disease and guide the choice of treatment options. Methods 52 cases of brucellosis from 2013-01-2016-01 were retrospectively analyzed. Brucellosis was diagnosed by cold agglutination test and imaging examination. 28 cases were treated with simple drug therapy, 3 cases were treated by minimally invasive interventional therapy, and 21 cases were treated by debridement and bone graft fusion and internal fixation. Results The group of 52 cases of brucellosis spondylitis according to imaging features: 9 cases of vertebral osteomyelitis, 8 cases of discitis, paravertebral abscess or epidural abscess in 5 cases, 30 cases of mixed type. 49 cases were followed up for 16 to 36 months, an average of 12 months. Curative effect according to Alp standard assessment: 47 cases were cured, improved in 2 cases. No recurrence of patients. Conclusions Brucellosis spondylitis has the characteristic imaging manifestations. Under the premise of effective drug treatment, minimally invasive or open surgery can be selected according to different imaging types.