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Hammami Fatma,Koubaa Makram,Feki Wiem,Chakroun Amal,Rekik Khaoula,Smaoui Fatma,Marrakchi Chakib,Mnif Zeineb,Jemaa Mounir Ben 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.6
Study Design: This was a retrospective study. Purpose: The aim was to compare the clinical, laboratory, radiological, and evolutionary features of tuberculous spondylodiscitis (TS) and brucellar spondylodiscitis (BS). Overview of Literature: Clinical presentation of spondylodiscitis varies according to the underlying etiology, among which brucellosis and tuberculosis represent the primary cause, in endemic countries. Only a few studies have compared the characteristics between TS and BS. Methods: A retrospective study was conducted using the data of all patients hospitalized for TS and BS in the infectious diseases department between 1991 and 2018. Results: Among a total of 117 patients, 73 had TS (62.4%) and 44 had BS (37.6%). Females were significantly more affected with TS than males (56.2% vs. 22.7%, p <0.001). Fever (72.7% vs. 45.2%, p =0.004) and sweating (72.7% vs. 47.9%, p =0.009) were significantly more frequent among patients with BS. The median erythrocyte sedimentation rate was significantly higher in the TS group (median, 70 mm/hr; interquartile range [IQR], 45–103 mm/hr) than in the BS group (median, 50 mm/hr; IQR, 16–75 mm/hr) (p =0.003). Thoracic involvement was significantly more frequent in the TS group (53.4% vs. 34.1%, p =0.04), whereas lumbar involvement was significantly more frequent in the BS group (72.7% vs. 49.3%, p =0.01). Initial imaging findings revealed significantly higher frequencies of posterior vertebral arch involvement, vertebral compaction, and spinal cord compression in the TS group. Percutaneous abscess drainage (20.5% vs. 2.3%, p =0.005) and surgical treatment (17.8% vs. 2.3%, p =0.01) were more frequently indicated in the TS group, with a significant difference. Conclusions: A combination of clinical, laboratory, and radiological features can be used to distinguish between TS and BS while these patients await diagnosis confirmation.
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