@article{3098934,
    title = "Surgical treatment of spinal brucellosis",
    author = "Katonis, Pavlos and Tzermiadianos, Michael and Gikas, Achilleas and and Papagelopoulos, Panayiotis and Hadjipavlou, Alexander",
    journal = "Clinical Orthopaedics and Related Research",
    year = "2006",
    number = "444",
    pages = "66-72",
    publisher = "Lippincott, Williams & Wilkins",
    issn = "0009-921X, 1528-1132",
    doi = "10.1097/01.blo.0000203455.59393.9a",
    abstract = "We retrospectively reviewed 10 patients with spinal brucellosis of the
thoracic and lumbar spine who were treated successfully with a
combination of surgery and antibiotics. All patients had back pain; six
patients had radiculopathy and one patient had paraparesis. Patients
with spondylodiscitis without epidural abscesses (n = 3) had
transpedicle discectomy and drainage. Epidural abscesses in the lumbar
area caused by spondylodiscitis (n = 3), spondylitis (n = 2), and
discitis with infected disc herniation (n = 1), were drained using a
posterior approach combined with posterolateral fusion in two patients
with spondylodiscitis and discectomy in the patient with a herniated
disc. One patient presented with a pathologic fracture and neural
compression and was treated with anterior corpectomy and reconstruction.
Antibiotic treatment was given for 3 to 9 months. Mean followup was 3
years. Back pain improved soon after surgery. Recovery from
radiculopathy and paraparesis was complete. One patient had recurrence
of infection 9 months after initial treatment. Clinical manifestation of
spinal brucellosis can include spondylitis, spondylodiscitis, discitis,
epidural abscess, paraspinal abscess, and vertebral collapse.
Transpedicle drainage allows tissue diagnosis and facilitates treatment.
Because brucellosis usually responds to antibiotics, surgery is
considered as the last resort in treating spinal brucellosis, but severe
neurologic deficit and incapacitating back pain often necessitate
surgical intervention."
}