Comparison of two surgical interventions for lumbar brucella spondylitis in adults: a retrospective analysis

Brucella osteoarthritis: recent progress and future directions

Brucellosis is a common zoonosis, and Brucella osteoarthritis is the most common chronic complication of brucellosis. Development of brucellosis osteoarthritis involves multiple organs, tissues, and cells. Brucella grows and multiplies in intrinsic cells of the skeleton, including osteoblasts, osteocyte and osteoclasts, which results in sustained release of bacteria that leads to exacerbation of the immune response. Concurrently, activation of the immune system caused by invasion with Brucella may affect the dynamic balance of the skeleton. A variety of in vitro and in vivo models have been employed to study Brucella osteoarthritis, such as using bone marrow-derived macrophages to establish cell models and mice to develop animal models of Brucella osteoarthritis. However, limited studies on the molecular pathological mechanisms of Brucella osteoarthritis have been performed and inadequate animal models have been developed due to the challenging parameters of Brucella research. This paper reviews recent advances in the clinical features, molecular pathological mechanisms, and animal models of Brucella osteoarticular infections. This review underscores the complexity of the pathogenesis of Brucella osteoarticular infections and highlights inflammation as a contributing factor to bone loss caused by Brucella. Additionally, the significant proliferation of Brucella in skeletal resident cells also is an important factor leading to bone loss. A deeper understanding of the molecular pathological mechanism of Brucella osteoarthrosis and their animal models could provide robust support for the prevention and treatment of Brucella osteoarticular disease.

Quantifying research hotspots and trends in brucella spondylitis: a bibliometric analysis

Background

Human brucellosis is the most common bacterial zoonosis worldwide, with brucella spondylitis (BS) being one of its most severe forms, potentially leading to spinal deformity or paralysis. This study aims to provide a comprehensive overview of the current status and research trends in the BS field using bibliometric methods.

Methods

Publications on BS from January 1, 1980, to March 24, 2024, were retrieved from the Web of Science database. We used Biblioshiny, VOSviewer, Scimago Graphica, CiteSpace, and Microsoft Office Excel Professional Plus 2016 to analyze publication frequency, geographic distribution, institutional affiliations, international collaborations, authorship, journal sources, keyword usage, trends, and cited references.

Results

Between January 1, 1980, and March 24, 2024, 197 publications on BS were analyzed. Turkey emerged as the leading contributor, with 62 publications, accounting for 31.47%. Weibin Sheng was the most prolific author, contributing 7 papers (3.55%). Xinjiang Medical University was the leading institution with 13 documents (6.60%). Medicine and Rheumatology International each published 6 papers (3.05%). CiteSpace analysis highlighted "spinal brucellosis," "spondylitis," "complications," "diagnosis," and "involvement" as the core research areas in BS. Keyword clustering analysis identified 11 primary clusters representing the main research directions. Analysis of abstracts and keyword trends revealed that post-2020, emerging research frontiers include "instrumentation," "management," and "debridement."

Conclusion

There has been significant progress in BS research, with a steady increase in publications. Current research focuses on diagnosis and complications, while future studies may explore management and instrumentation. Increased collaboration among countries and researchers is recommended.

A Novel Differentiation Nomogram Model for Brucellar Spondylitis and Tuberculous Spondylitis

Background

Tuberculous spondylitis (TS) and brucellar spondylitis (BS) exhibit certain similarities in clinical presentation and imaging characteristics, making differential diagnosis challenging. Developing a reliable differential diagnosis model can assist clinicians in distinguishing between these two conditions at an early stage, allowing for targeted prevention and treatment strategies.

Methods

Patients diagnosed with TS and BS were retrospectively collected and randomized into training and validation cohorts (ratio 7:3). The least absolute shrinkage and selection operator (LASSO) regression was used to reduce data dimensionality and select variables. Multivariate logistic regression was used to build predictive models. A nomogram was constructed to provide a visual representation of the model. Receiver operating characteristic (ROC) curve, calibration plots and decision curve analysis (DCA) were used to measure the predictive performance of the nomogram.

Results

A total of 183 patients included (101 cases of TB, 82 cases of BS) our study. Our results showed that these variables including time from symptom onset to admission, anorexia, adenosine deaminase (ADA) and psoas abscess were important to differentiate TS and BS. The area under the curve (AUC) of ROC curve was 0.820 [95% CI (0.749, 0.892)] and 0.899 [95% CI (0.823, 0.976)] for the training and validation cohort, respectively. The results of calibration curve and DCA confirmed that the nomogram performed well in differentiating TS patient from BS.

Conclusion

The combination of time from symptom onset to admission, anorexia, ADA and psoas abscess demonstrated good differential properties for TS and BS. We developed a new nomogram model that can effectively differentiate TS and BS based on these four characteristics, which could be a valid and useful clinical tool for clinicians to aid in early differential diagnosis and targeted treatment.

Brucella Spondylitis: Current Knowledge and Recent Advances

The most prevalent zoonotic disease is brucellosis, which poses a significant threat for worldwide public health. Particularly in endemic areas, spinal involvement is a major source of morbidity and mortality and can complicate the course of the disease. The diagnosis of Brucella spondylitis is challenging and should be suspected in the appropriate epidemiological and clinical context, in correlation with microbiological and radiological findings. Treatment depends largely on the affected parts of the body. Available treatment options include antibiotic administration for an adequate period of time and, when appropriate, surgical intervention. In this article, we examined the most recent data on the pathophysiology, clinical manifestation, diagnosis, and management of spinal brucellosis in adults.