Anterior cervical discectomy and fusion in treating acute myelopathy caused by Brucella cervical spondylitis: a case series
Background and Objectives Cervical disease caused by Brucella infection is rare, with acute spinal cord impairment due to myelitis being a severe complication. If untreated, it can lead to significant patient damage. This study aims to begin to investigate the clinical characteristics of acute cervi...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2493308 |
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| Summary: | Background and Objectives Cervical disease caused by Brucella infection is rare, with acute spinal cord impairment due to myelitis being a severe complication. If untreated, it can lead to significant patient damage. This study aims to begin to investigate the clinical characteristics of acute cervical myelitis caused by Brucella infection and to evaluate the profile of clinical benefit of anterior cervical discectomy and fusion (ACDF) for this condition.Methods This retrospective case series included 6 patients who underwent surgical treatment for acute cervical spinal cord impairment due to Brucella infection at our institution between January 1, 2013, and January 1, 2023. Clinical data such as age, gender, surgery duration, follow-up period, medication duration, time to bone fusion, ASIA classification, Visual Analog Scale (VAS) score, Japanese Orthopaedic Association (JOA) score, and Neck Disability Index (NDI) score were collected both preoperatively and postoperatively. Statistical analysis was used to assess the clinical benefits of ACDF surgery.Results Six patients (4 males, 2 females) underwent successful ACDF. The median age was 52.5 years. The median surgery duration was 130.0 min, and the median hospital stay was 13.5 days. The median follow-up period was 15.0 months, and the median duration of postoperative medication was 16.0 weeks. All patients achieved satisfactory bone graft fusion, with a median fusion time of 4.0 months. ASIA classifications improved in all patients. Three patients improved from grade C to grade E, two from grade B to grades D and E, and one from grade C to grade D. The median VAS score decreased from 6.0 preoperatively to 0.0 at follow-up. The median JOA score increased from 6.0 to 17.0, and the NDI score improved from 29.5 to 4.5. No recurrence of infection or neurological symptoms was observed during follow-up.Conclusion Acute cervical spinal cord impairment from Brucella infection is rare and challenging to diagnose early. However, early ACDF application effectively relieved spinal cord compression, improved neurological symptoms, and enhanced patient outcomes, demonstrating its efficacy for treating acute myelitis caused by Brucella infection. |
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| ISSN: | 0785-3890 1365-2060 |