Clinical epidemiological characteristics and treatment outcomes of Brucella spondylitis in Ningxia, China: a 12‑year single‑center retrospective study.

BACKGROUND: Epidemiological and clinical analyses of Brucellar spondylitis (BS) are crucial for public health authorities to enhance disease surveillance and optimize case management strategies. However, clinical epidemiological research on BS remains limited. This study analyzed the clinical and epidemiological characteristics of hospitalized BS patients at a hospital in Ningxia, aiming to provide evidence to support region-specific strategies for BS prevention and control. METHODS: We retrospectively collected demographic profiles, epidemiological characteristics, clinical presentations, laboratory/imaging findings, therapeutic regimens, and prognostic outcomes of BS inpatients admitted to the orthopedic department of a hospital in Ningxia from January 2012 to December 2023. RESULTS: A total of 821 patients with BS were included, consisting of 564 males (68.7%; 564/821) and 257 females (31.3%; 257/821), with a median age of 55 years (range: 18-88 years). Among all patients (n = 821), 466 (56.76%) were agricultural or pastoral workers, and 578 (70.4%) had a documented history of contact with cattle or sheep. Low back pain was the most common presenting symptom, reported in 779 cases (94.88%; 779/821). The combined positive rate of the Rose Bengal Plate Test (RBPT) and the Standard Agglutination Test (SAT) in serological testing was 90.99% (747/821). Blood cultures were performed in 618 patients, of whom 217 (35.11%; 217/618) yielded positive results. Imaging examinations revealed that the lumbar spine was the most frequently involved region (59.81%; 491/821), with the L4-L5 segment being the most commonly affected (20.83%; 171/821). Single-segment involvement was observed in 668 patients (81.37%; 668/821), single-vertebra involvement in 44 patients (5.36%; 44/821), and multi-segment or trans-segment involvement in 109 patients (13.28%; 109/821). Of the 465 patients who underwent surgical treatment, the most common procedure was posterior fixation combined with lesion debridement, performed in 215 cases (46.24%; 215/465). Among the 754 patients who completed follow-up, the most frequently used antibiotic regimen was doxycycline plus rifampicin (60.05%; 493/754). Relapse occurred in 26 patients during follow-up (3.45%; 26/754). CONCLUSION: Brucellar spondylitis in Ningxia exhibits a temporal pattern aligned with regional brucellosis trends. Strengthening imaging-based diagnosis, clinical evaluation, and targeted follow-up of high-risk populations may help reduce recurrence and improve disease control. CLINICAL TRIAL: Not applicable.