Brucellar, pyogenic and tubercular infections of spine: comparative study of haematological, radiological features and treatment outcome

Abstract

Spinal infections can also be described as pyogenic, granulomatous (tuberculous, brucella, fungal) and parasitic. Tubercular spondylodiscitis is the commonest. Although a wide range of organisms have been associated with spondylodiscitis, it remains primarily a monomicrobial bacterial infection. A detailed evaluation of clinical features- fever, back pain (Visual Analogue score), discharging sinus, swelling, deformity, neurological status (graded as per charting by Kumar and Tuli; ASIA scale (American Spinal Injury Association). In 7.6% of NTS and 9.1% of TS, the tissue specimen was obtained by closed vertebral biopsy and in 80.7% of NTS and 90.9% of TS by open biopsy at the time of surgery. The yield of culture of the biopsy specimen was 100% in PS and 21% In BS. AFB stain was positive in 32.1% and PCR was positive in 82.8% of TS. 119 (83.3%) patients were treated by anterior decompression, biopsy posterior spinal instrumentation and global fusion.13 (8.6%) patients were treated by debridement, abscess drainage +/-antibiotic bead application.