关键词: 脊柱感染, 原发性化脓性脊柱感染, 结核性脊柱感染, 布氏杆菌性脊柱感染

Abstract:

Objective To explore clinical characteristics of patients with primary pyogenic spinal infection (PSI), tuberculous spinal infection (TSI) and Brucella spinal infection (BSI). Methods The Clinical data of 79 patients with primary spinal infection (PSI) admitted to the Third Hospital of Hebei Medical University from January 2016 to December 2020 were retrospectively analyzed and statistically analyzed. Results The percentage of neutrophils, C-reactive protein (CRP), and procalcitonin (PCT) on admission in the PSI group were higher than those in the TSI group and BSI group, and the white blood cell count(WBC) in the PSI group was higher than that of the BSI group; the TSI group had a longer onset time and lower erythrocyte sedimentation rate(ESR) compared with those of the PSI group, and the differences were statistically significant(P<0.05). The most common clinical symptom of spinal infection was neck or back pain [69 cases (87.3%)], followed by the fever or chills [39 cases (49.4%)]. The proportion of patients with symptoms involving the fever or chill in the PSI group was higher than those of the TSI group, and the difference was statistically significant (P<0.017). Lumbosacral site was the most frequently involved site in the three groups, being 28 (87.5%), 16 (57.1%), and 16 (84.2%) cases, respectively. However, cervical or thoracic involvement was more common in the TSI group than in the PSI group, and the difference was statistically significant (P<0.017). The proportion of paravertebral abscess and psoas abscess in the TSI group was higher than that of the PSI group and the BSI group, and the difference was statistically significant (P<0.017). Conclusion The patient has the fever or chills, significantly increasing non-specific inflammatory indicators, and acute onset shows PSI. The involved site is the cervicothoracic spine, multiple segments are involved, paravertebral abscess and psoas abscess are companied, and a longer course of disease shows TSI. History of close contact with livestock or animal products, slight increase in non-specific indicator, mild vertebral body damage and anterior osteophyte formation, and slight paravertebral abscess suggests BSI.

Key words: spinal infection, primary pyogenic spinal infection, tuberculous spinal infection, brucella spinal infection