Clinical Effect of Doxycycline Combined with Compound Sulfamethoxazole and Rifampicin in the Treatment of Brucellosis Spondylitis.

OBJECTIVE: The purpose of this study was to determine the clinical value of triple antibiotic therapy consisting of doxycycline, compound sulfamethoxazole and rifampicin in the treatment of brucellosis spondylitis. METHODS: A retrospective analysis was performed on 100 patients with brucellosis spondylitis admitted to the First Affiliated Hospital of Hebei North University from March 2016 to June 2019. Patients were divided into the following two groups: the control group (n = 50) treated with dual antibiotic therapy (rifampicin + compound sulfamethoxazole), and the observation group (n = 50) treated with triple antibiotic therapy (rifampicin + doxycycline + compound sulfamethoxazole). The treatment effect, low back pain relief, levels of erythrocyte sedimentation rate (ESR), procalcitonin (PCT) and C-reactive protein (CRP), as well as the adverse reactions were compared between the two groups. RESULTS: The response rate of the observation group was significantly higher than that of the control group (P < 0.05). Before treatment, there was no significant difference in the low back pain assessed by the visual analogue scale (VAS), or levels of ESR, PCT and CRP between the two groups (P > 0.05). But after treatment, the VAS score and the levels of ESR, PCT and CRP in observation group were lower than those in the control group (P < 0.05). No significant difference was found in the incidence of adverse reactions (P > 0.05). CONCLUSION: The triple antibiotic therapy of doxycycline, compound sulfamethoxazole and rifampicin is effective in the treatment of brucellosis spondylitis. It can significantly alleviate patients' back pain and inflammation with a high safety profile, which is worthy of clinical application.

Effect of Crosslinks on the Stability of the Spine and the Pedicle Screw Fixation.

OBJECTIVE: To evaluate the effect of crosslinks on the stability of the spine and pedicle screws. METHODS: Compression fracture of the L1 vertebra was produced in 30 fresh thoracic and lumbar vertebrae samples obtained from adult sheep, which were divided into 3 groups (n=10)with lot-drawing method. Four screws were fixed onto the superior and inferior pedicles of vertebral arch close to the fractured vertebrae, with different number of crosslinks (0 in Group A,1 in Group B, and 2 in Group C) on the rods. After fixation, the samples were subject to 10 000 times of fatigue test with 1.5 Hz load on the HY-3080 computer-control electronic universal test machine and HY-1000NM computer-control torsion test machine. The axial compressive stiffness, maximum pullout strength,and range of motion (ROM) of 6 directions, i.e., flexion, extension, left and right lateral bending, and left and right axial rotation of the 3 groups were measured and compared. RESULTS: There were no statistically significant differences in axial compressive stiffness as well as the ROM of flexion, extension, and left and right lateral bending (all P>0.05). The maximum pullout strength was significantly smaller in Group A and Group B than in Group C [(129.56±29.63)N vs.(294.67±23.25) N,P=0.000;(254.02±36.29)vs.(294.67±23.25)N, P=0.006]. The ROM of left axial rotation was the highest in Group A(13.35°±1.06°), followed by Group B(12.23°±1.06°)and Group C (11.04°±0.74°)(F=13.44, P=0.000; Group B vs. Group A, P=0.000; Group B vs. Group C, P=0.001; Group C vs. Group A,P=0.000). The ROM of right axial rotation was also the highest in Group A(13.56°±1.15°), lower in Group B (12.39°±1.01°) and the lowest in Group C (10.81°±0.51°) (F=21.91, P=0.000; Group B vs. Group A,P=0.002; Group B vs. Group C, P=0.001; Group C vs. Group A, P=0.000). CONCLUSION: Crosslinks may reinforce the pullout strength of the screws and improve the axial stability of the spine.