ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Differences analysis between spinal tuberculosis and brucella spondylitis with preoperative non-invasive differential diagnosis.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Preoperative differentiation of spinal tuberculosis, pyogenic, and brucellar spondylitis: a multimodal machine learning study across five centers.Frontiers in cellular and infection microbiology · 2026Article
- Metagenomic Next-Generation Sequencing in Brucellar Spondylitis with Discordant Serologic Findings in a Non-Endemic Region: A Case Report and Literature Review.Infection and drug resistance · 2026Article
- Analysis of High-Risk Factors for Tuberculosis Retreatment Based on Machine Learning and Latent Class Analysis.Infection and drug resistance · 2026Article
- A novel diagnostic model for brucellosis spondylitis using serum PINP and inflammatory factors: a dual-cohort study from Northwest China.BMC infectious diseases · 2025Article
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Authors and funding
8 authors.
Funding
Abstract
objectiveSpinal tuberculosis (STB) and Brucella spondylitis (BS) represent two types of granulomatous infections affecting the spine, which exhibit significant similarities that often result in misdiagnosis and overlooked diagnoses during preoperative evaluations. This study aims to identify non-invasive evaluative indicators that facilitate the differentiation between STB and BS.
methodsThis study conducted a retrospective collection of clinical features, laboratory tests, and imaging characteristics from 89 patients diagnosed with STB and 66 patients diagnosed with BS. Differences were assessed utilizing χ² tests, independent non-parametric tests, Mann-Whitney U tests, or Fisher's exact tests. Binary logistic regression analysis was employed to identify independent predictive factors for differential diagnosis, and receiver operating characteristic (ROC) curves were generated to assess the effectiveness by calculating the area under the curve (AUC).
resultsRoot symptoms (including limb pain and numbness) and necrosis formation exhibited statistically significant differences, with P values of 0.024 and 0.045, respectively. Furthermore, gender, decreased A/G ratio, involvement of thoracic vertebrae, number of damaged vertebrae, and straightening of spinal curvature were identified as independent predictive factors for differentiating between STB and BS, with P values of 0.009, 0.003, < 0.001, 0.005, and 0.014, respectively. ROC analysis revealed that the AUC and 95% confidence intervals (CIs) for these five evaluative indicators were 0.626 (0.537-0.714), 0.621 (0.533-0.709), 0.694 (0.612-0.777), 0.597 (0.508-0.686), and 0.631 (0.540-0.722), respectively. The predictive model exhibited an AUC and 95% CI of 0.854 (0.796-0.911), indicating strong predictive performance.
conclusionStatistically significant differences were observed between STB and BS regarding root symptoms and necrosis formation. In cases where the patient is male, presents with a decreased A/G ratio, does not have thoracic vertebra involvement, number of vertebral body destructions < 2.5, and exhibits straightening of spinal curvature, the likelihood of diagnosing BS is significantly greater than that of STB.
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