To explore the clinical efficacy of one-stage posterior computer navigation-assisted pedicle screw placement, lesion removal, intervertebral bone graft fusion and internal fixation in the treatment of thoracic brucellosis spondylitis.

From September 2015 to October 2019, 19 patients with thoracic brucellosis spondylitis were retrospectively analyzed. There were 12 males and 7 females, aged from 28-66 years (average, 46.8 ± 11.0 years old). All patients had chest and back pain, 13 (68.4%) patients had different degrees of sensory and motor dysfunction, and all the patients underwent one-stage posterior computer navigation-assisted pedicle screw placement, lesion removal, intervertebral bone graft fusion and internal fixation. The Visual Analogue Scales (VAS), American Spinal Injury Association (ASIA), Erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP) are used for clinical efficacy evaluation.

Postoperatively, 112 pedicle screws were located in Grade I, and the accuracy rate of screw placement was 93.3% (112/120). The follow-up was 12-36 months, with an average (20.9 ± 6.6) months. The chest and back pain of all patients was significantly reduced after surgery, and the sensory motor function was significantly improved. At 2 weeks after operation, 3 months after operation and the last follow-up, the VAS score was statistically different from that before operation (all P < 0.001), but there was no statistical difference between the last follow-up and 3 months after operation (Z =-1.414, P = 0.157). At 2 weeks after operation, ESR and CRP were statistically different from those before operation (all P < 0.001). At 3 months after operation, ESR and CRP basically dropped to normal. At 3 months after operation and the last follow-up, ESR and CRP were statistically different from those before and 2 weeks after operation (all P < 0.001), but there was no statistical difference between the last follow-up and 3 months after operation (t = 2.464, P = 0.053; t = 1.711, P = 0.102). The ASIA classification of 13 patients with spinal cord or nerve compression symptoms before the operation was 1 case of grade B, 2 cases of grade C and 10 cases of grade D. At the last follow-up, there were 2 cases of grade D and 11 cases of grade E, with statistical difference (χ² = 11.621, P = 0.009). In addition, all patients had bone graft fusion at the last follow-up without complications such as recurrence, loosening of internal fixation and displacement.

The treatment of thoracic brucellosis spondylitis with the aid of computer navigation has the characteristics of high accuracy of pedicle screw placement, and can effectively remove the lesion tissue, eliminate chest and back pain, and restore sensory and motor function. The clinical effect is satisfactory.