Imaging study to establish the classification criteria of brucellar spondylitis based on MRI findings

Abstract

Objective: Establishment of brucellosis spondylitis of imaging classification; provision reference for clinical treatment methods. Methods: Form January 2008 to July 2012, 89 cases imaging data confirmed by clinical examination and laboratory of brucellosis spondylitis patients were analyzed retrospectively, based on X-ray, CT and MRI imaging of their clinical manifestations- Vertebral inflammatory infiltration and extent of the damage, the extent of damage to the intervertebral space, periostitis inflammatory changes, paraspinal abscess, spinal cord, cauda equina and nerve root compression. All this imaging indicators above were the evaluation criteria. Acquisition and analysis of the imaging data was implemented by the blinded reading group which was composed of Imaging Center physicians and orthopedic surgeons. According to these imaging performances, develop the imaging classification. Results: Brucellosis spondylitis image was made up of I-VI type: type I: vertebral inflammation; type II: Discitis; type III: periostitis; type IV: abscess; type V: spinal nerve and type VI: compound. The group of 54 cases accounted for 60.67% of the compound, in which the incidence of type I Image companied by type II was maximum: 22 cases accounted for 40.74% (22/54) and second type II Image and companied by V type was 20 cases: accounted for 37.03% (20/54). In the group, 35 cases of simple type accounted for 39.33%: type I: 4 cases; type II: 12 cases; type III: 3 cases; type IV: 2 cases; type: 4 cases. Simple and complex type of type II imaging accounted for 59.55% (53/89) the highest occurrence rate, in which the type I was 47 cases: accounted for 52.81% (47/89). Based on imaging classification, 67 cases was treated by surgery, in which 59 cases was treated by debridement and 8 cases was treated by percutaneous minimally invasive surgery, 22 cases was not treated by surgery. The group of 89 cases had been followed for 1 year: 83 cases had been cured without prognosis, and 6 cases had been improved. Conclusion: Brucellosis spondylitis images classification has a reference value and guiding significance for the strategies of clinical treatment. According to this classification, simply type I, type II, type III, and IV type can be used in clinical conservative treatment, and when the evolution of the disease has surgical indications, or type V and VI type the patients should be treated actively by surgery