The Assessment of the Clinical Effect of the Drug Compatibility and Course of Treatment to the Brucellar Spondylitis

Yang, Xinming; We, Shi; Meng, Xianyong; Zhang, Ying; Du, Yuchen; Zhang, Lei; Wang, Yao-Yi

doi:10.4236/ss.2013.41017

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…62 elderly patients met BS confirmed cases. [16]; reported in the literature that the cure rate for BS is about 85%, and about 95% efficiency [4]. Ioannou confirmed through research that no matter which treatment plan is adopted, the longer-term treatment plan is positively correlated with the lower failure rate, which is consistent with the results reported by Seyed [16]…”

Section: Bs Clinical Characteristics and Diagnosissupporting

confidence: 77%

The Senile Brucellosis Spondylitis Clinical Diagnosis and Treatment on as Evaluation Were Retrospectively Analyzed

Yao¹,

Yang²

2018

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Objective: To explore senile brucellosis spondylitis clinical features and diagnostic criteria, in order to improve the diagnosis rate and evaluate the clinical effects of treatment strategies. Methods: From January 2002 to August 2015, 62 patients with Brucella-associated spondylitis were treated with comprehensive diagnosis based on epidemiological history, clinical manifestations, imaging findings, laboratory tests, and local biopsy. The positive rate of red plate agglutination test (RBPT) was 45.1%, the positive rate of serum tube agglutination test (SAT) was 51.6%, and the positive rate of brucellosis anti-human immunoglobulin test (Coomb's) was 100%. All patients underwent X-ray, CT and MRI examinations. The positive rate of blood culture in pathogenic examination was 16.1%, and the positive rate of bone marrow culture was 38.5%. The positive rate of inflammatory granuloma or abscess in the lesion sampling culture was 73.6%. All patients underwent standardized drug therapy and hyperbaric oxygen adjuvant therapy. Among them, 38 patients with neurological impairment were treated with one-stage debridement and posterior pedicle screw fixation on the basis of drug therapy. The paraspinal abscess and the diseased intervertebral space tissue were taken for pathological examination during the operation. One week, two weeks, one month, three months, six months and 12 months after treatment, the patients were evaluated and followed up at the monitoring sites. The evaluation indicators were pain scores, activity of daily living (ADL), imaging findings, and laboratory tests. The SPSS15.0 statistical package was used for analysis. Results: All patients were confirmed by the above-mentioned comprehensive examination after admission. 24 patients (38.71%) were treated with standard drug therapy (group A), no adverse drug reactions and abnormal liver and kidney function; the remaining 38 patients (61.29%) were combined with va-How to cite this paper: Yao, Y. and Yang, X.M.

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Section: Bs Clinical Characteristics and Diagnosissupporting

confidence: 77%

The Senile Brucellosis Spondylitis Clinical Diagnosis and Treatment on as Evaluation Were Retrospectively Analyzed

Yao¹,

Yang²

2018

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“…Before the operation, individualized anti-brucellosis medications were administered, using a combination, appropriate amount, regular and full-course administration. For con rmed cases, doxycycline + rifampicin + sulfamethoxazole is the rst choice [7]. The dose of the drug is based on the weight, liver and kidney function of the patient.…”

Section: General Informationmentioning

confidence: 99%

“…It is observed in clinical application that drug resistance rate increases gradually due to non-standard drug treatment in recent years. Tetracycline plus streptomycin, or drug replacement based on this regimen for the treatment of brucellosis recommended in the World Health Organization (WHO) joint bulletin, has an effective rate of only 60%, Liver and kidney function damage is greater, the long-term effect is not good, and the recurrence rate is high [7,16,17]. How to improve the cure rate of brucella spondylitis, reduce the recurrence rate, reduce brucella resistance and drug toxicity, to avoid liver and kidney function damage, therefore, the establishment of personalized drug treatment system is very necessary.…”

Section: The Necessity Of the Establishment Of The System Of One-stagmentioning

confidence: 99%

“…These include paraspinal abscesses and intraspinal in ammatory granulation tissue, abscesses, necrotic intervertebral discs, and damaged cartilaginous surfaces. It has a good effect on controlling the development of the lesion and relieve pain and reduce complications.This operation is performed at the cost of destroying and sacri cing normal tissue to enlarge the wound, and it lacks objective criteria for complete lesion remova.With individualized sensitive drugs pertinence treatment most brucidosis spondylitis can be cured by conservative treatment [4,7].Therefore, from the perspective of promoting the recovery of focal infection, the removal of focal disease is no longer the sole objective of surgical treatment.The main objective of surgical treatment shifted from focusing on the extensive removal of lesions to focusing on the removal of large abscesses that were di cult to absorb and the removal of intraspinal compression of the nervous system to the restoration of spinal stability and the promotion of early recovery [23][24][25].Postoperative recurrence of brucellosis spondylitis is related to the destruction of spinal stability, and the reconstruction of spinal stability is the key to the success of surgical treatment of infectious spondylitis [10][11][12]18,19,24].In the research progress of brucellosis spondylitis, domestic and foreign scholars such as Ulu-Kilic A [14,26,27]elaborated that the main limitations of brucellosis spondylitis abscess were distributed in the paraspinal and spinal canal, and the main clinical manifestation was nerve injury caused by spinal cord cauda equina compression.The purpose of clearing the lesion and restoring the nerve function could be achieved through windowing surgery.In this study, the principle of lesion removal was to remove paraspinal di cult to absorb abscess and intraspinal granulation tissue, intervertebral disc, relieve nerve compression and spinal xation by limited exposure with less trauma. One-stage posterior approach for limited lesion removal and internal xation surgery was performed.…”

Section: Advantages Of One-stage Posterior Limited Lesion Clearance Fmentioning

confidence: 99%

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Establishment and Clinical Application of One-stage Posterior Limited Lesion Clearanceand Internal Fixation Combined With Personalized Drug Therapy System for Brucellosis Spondylitis

Yang

Tian

Yao

2021

Preprint

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ObjectiveTo investigate the feasibility and clinical effect of one-stage posterior limited lesion clearance and internal fixation combined with individualized drugs in the treatment of brucidosis spondylitis.Methods44 patients who conform to inclusion criteria, including 2 cases thoracolumbar segment, 32 cases lumbar segment and 10 cases lumbosacral segment. Preoperative VAS(Visua Analogue Scales) 5~8,ODI(Oswestry disability index) 51.15~84.36%, Body Mass Index （BMI） 16.2~17.5, American Spinal Injury Association（ASIA）classification C grade 6 and D grade 10. Magnetic Resonance Imaging（MRI） showed compression of dural sac in 16 cases. Preoperative medication regimen was developed according to the patient's medication allergy history, weight, liver and kidney function, and T-lymphocyte spot test（T-SOPT）.ResultsPostoperative individualized medication was used according to the drug sensitivity test and T-SOPT to select 3 kinds of sensitive drugs for 2 courses of treatment, and the patients were clinically cured 3 to 9 months. The evaluation indexes of Erythrocyte Sedimentation Rate （ESR）, C-reactive protein （CRP）, Rose Bengal Plate agglutination Test （RBPT）, VAS,BMI,ASIA,ODI and MRI at each time point were significantly improved compared with those before surgery (P<0.05). Follow-up showed that the lesions were completely cleared, inflammation was absorbed, pedicle screw fixation was good, spine stable, intervertebral bone grafting was fused, and the spinal cord were well aligned without compression.ConclusionPersonalized medication is highly targeted, conforms to pharmacokinetics, has low toxic and side effects, no drug allergy or drug resistance, so as to reduce medical expenses and obtain the maximum clinical efficacy with the minimum cost. One-stage posterior limited lesion clearance and internal fixation surgery has little trauma, and the lesions are completely removed. The correct choice of screw placement and short segment internal fixation of diseased vertebra is safe and reliable.

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Advances in the Diagnosis and Treatment of <i>Brucella </i>Spondylitis

李

2024

ACM

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The Assessment of the Clinical Effect of the Drug Compatibility and Course of Treatment to the Brucellar Spondylitis

Cited by 4 publications

References 17 publications

The Senile Brucellosis Spondylitis Clinical Diagnosis and Treatment on as Evaluation Were Retrospectively Analyzed

The Senile Brucellosis Spondylitis Clinical Diagnosis and Treatment on as Evaluation Were Retrospectively Analyzed

Establishment and Clinical Application of One-stage Posterior Limited Lesion Clearanceand Internal Fixation Combined With Personalized Drug Therapy System for Brucellosis Spondylitis

Advances in the Diagnosis and Treatment of <i>Brucella </i>Spondylitis

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