Anterior debridement, reconstruction, and fusion for cervical brucellosis spondylitis with epidural abscess: a single-center experience of 30 patients.

Objective: To evaluate the efficacy of anterior debridement, reconstruction, and fusion for cervical brucellosis spondylitis with epidural abscess (CBS-EA).

Methods: The clinical data of patients with CBS-EA who underwent anterior debridement, reconstruction, and fusion from January 2012 to January 2023 were retrospectively reviewed. The surgical duration and estimated blood loss volume were documented. The regional lordosis angle (RLA) and C2-C7 Cobb angle were analyzed to determine the improvement in cervical alignment. Frankel grading was used to evaluate neurological function. The visual analog scale (VAS) and Japanese Orthopedic Association (JOA) scores were assessed to determine the relief of neck pain and functional recovery. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were analyzed to evaluate infection control. Bony fusion was also documented.

Results: Overall, 30 patients were eligible for inclusion, including 25 males and five females. The mean age was 54.2 ± 11.6 years. The surgical duration was 149.8 ± 28.7 min, with an estimated blood loss volume of 98.0 ± 56.9 mL. The RLA increased from 1.4° ± 6.8° preoperatively to 8.5° ± 5.2° postoperatively, and the RLA was 5.8° ± 4.5° at the final follow-up (P < 0.01). The C2-C7 Cobb angle was 8.7° ± 11.4° preoperatively, 18.1° ± 9.0° postoperatively, and 14.0° ± 8.2° at the final follow-up (P < 0.01). For patients with neurological deficit, significant improvement in Frankel grading was observed. The VAS and JOA scores improved significantly postoperatively. CRP and ESR returned to normal range during follow-up, and bony fusion was achieved in all patients.

Conclusions: Collectively, anterior debridement, reconstruction, and fusion may be effective surgical strategies for CBS-EA with favorable clinical outcomes.