a patient with spinal brucellosis and lumbar disc herniation: case report

Is Spinal brucellosis a differential diagnosis?

Diagnosing spinal brucellosis can be challenging. These infections may present in an unusual fashion. Although rare, spinal brucellosis must remain as a differential diagnosis in any patient presenting with low back pain and fevers.

Is Spinal brucellosis still a potential diagnosis for sciatica?

Brucellosis should continue to be considered as a potential diagnosis for patients with sciatica, axial back pain, and septic arthritis. Clinical Message Diagnosing spinal brucellosis can be challenging.

What is the pathophysiology of brucellosis?

Brucellosis is caused by an intra-cellular bacterium of the genus Brucella, which can routinely infect many organ systems, tissues, and lead to systemic changes [2]. Infected farm animals are prominent vectors of brucellosis and are a primary source of transmission to humans [4].

Can Brucella cause spondylitis?

Brucellosis may infect the vertebral body causing spondylitis, the vertebral disc causing discitis, or both resulting in spondylodiscitis [6]. Brucellar spondylitis, or the infection of the vertebrae secondary to Brucella, is most commonly seen in men older than 40 years of age and has a prevalence rate of 2–60% [6, 8, 9].

What is used to pull out herniated disc fragments?

Disc fragments (stained with Indigo Carmine; see Figure 7B below) are identified and removed with pituitary ronguers. Straight and angled graspers are then used to pull out herniated disc fragments. Frayed edges of the annular tear are ablated using the Ellman radiofrequency probe and YAG holmium side-firing laser (Figures 6A, 6B, video) to complete the discectomy.

How to assess decompression?

The decompression is assessed by visualizing the traversing and exiting nerve roots, and probing the canal with the curved ball-tip probe (Figure 7A). The probe is observed to pass easily through the path of the exiting nerve root, across the midline of the canal, and down the path of the traversing nerve root, past the pedicle.

Is scoliosis a long standing problem?

Her underlying scoliosis is a long-standing problem that has been managed nonoperatively, and the goal was to continue nonoperativ e treatment of this more extensive problem.