To investigate the single-stage posterior surgery surgical treatment of lumbar brucellosis spondylitis combined with lumbar spondylolisthesis, and evaluate its clinical efficacy.

The clinical data of 16 patients with lumbar brucellosis spondylitis combined with lumbar spondylolisthesis collected in Beijing Ditan Hospital, Capital Medical University from July 2015 to March 2019 were analyzed, retrospectively, including 14 males and 2 females, aged from 46 to 68 years old, with an average of (59.2 ± 6.5) years old, who were treated through one-stage posterior lumbar lesion removal, reduction, decompression, internal fixation, and bone graft fusion. The postoperative follow-up were 12 to 36 months, with an average of (25.0 ± 8.1) months. The reduction rate of spondylolisthesis, reduction loss rate, bone graft fusion rate and complication rate after surgery were recorded. At the same time, the visual analogue scale (VAS), the Japanese orthopaedic association scores (JOA), the oswestry disability index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and rose bengal plate agglutination test (RBP) before and after the operation were compared to evaluate the clinical efficacy.

VAS score decreased from 8.0 (8.0, 8.8) preoperatively to 2.0 (1.3, 2.0) and 0.0 (0.0, 1.0) at 2 weeks and 1 year after operation, respectively. JOA score increased from the average (11.8 ± 3.6) preoperatively to (18.6 ± 2.3) and (23.6 ± 2.7) at 2 weeks and 1 year after operation, respectively. ODI index decreased from (88.5 ± 5.6) % preoperatively to (35.7 ± 3.1) % and (9.3 ± 5.7) % at 2 weeks and 1 year after operation, respectively. ESR decreased from 35.5 (14.5, 43.0) mm/h preoperatively to (12.9 ± 5.3) mm/h and (9.2 ± 3.6) mm/h at 2 weeks and 1 year after operation, respectively. CRP decreased from (20.3 ± 10.2) mg/L preoperatively to (7.6 ± 3.1) and (3.5 ± 1.7) mg/L at 2 weeks and 1 year the operation, respectively. Two weeks after surgery and one year after surgery, VAS, JOA, ODI, ESR and CRP were significantly different from those before surgery (all P < 0.001). Moreover, VAS, JOA, ODI, ESR and CRP were statistically different at 1 year after operation compared with 2 weeks after operation (all P < 0.001). The average reduction rate of spondylolisthesis 2 weeks after surgery was (91.2 ± 6.7)% and the median loss rate of reduction at 1 year after surgery was 8.0 (5.0, 9.8)%. During the last follow-up, all patients obtained bony fusion, no internal fixation loosening, displacement, breakage, etc and no recurrence occured.

One-stage posterior lumbar lesion removal, reduction, decompression, internal fixation, and bone graft fusion are feasible for the treatment of lumbar brucellosis spondylitis combined with lumbar spondylolisthesis. The reconstruction of spinal stability could relieve pain, heal lesions and improve the ability to live independently.