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case_images: Results of cervical X-ray (A), CT (B and C) and MRI (D-I) on June 1, 2021 in our hospital. Lesion areas are labelled by white arrows and dashed boxes. CT results showed MRI results showing partial absorption of abscess without significant aggravation compared to MRI on April 27 ((D and E) is cervical sagittal, (F) is cervical horizontal, T1WI; (G and H) is cervical sagittal, (I) is cervical horizontal, T2WI).
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case_images: Imaging studies, including X-rays, CT, and MRI scans of the cervical spine, demonstrated destructive spondylitis at the C7 vertebral level with paravertebral abscess formation (Figure 1).
case_images: (A) Abscesses at C6, C7 and T1 were cleared; (B) Pathological samples of abscesses were taken during the operation; (C and D) Subtotal resection was performed on C7, titanium mesh filled with appropriate artificial bone, 2 screws were inserted at C6 and T1 respectively, and appropriate titanium plate fixation was selected. Lesion areas are labelled by white arrows and dashed boxes.
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case_images: The patient underwent anterior cervical debridement and decompression, C7 subtotal corpectomy, and titanium mesh bone graft fusion, with a cervical titanium plate for internal fixation (Figure 2).
case_images: (A) A large number of Brucella (1000x) can be seen in postoperative pathological Gram staining; (B) RT-PCR detects Brucella melitensis DNA at cycle 34 (red solid line Brucella melitensis; blue solid line Brucella canis; red dashed line Brucella bovis; blue dashed line Brucella suis); (C) TB DNA was not detected by RT-PCR (red solid line for tuberculosis; blue solid line for normal).
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case_images: Pathology from intraoperative samples confirmed extensive Brucella involvement via Gram staining and RT-PCR, while tuberculosis was excluded (Figure 3).
case_images: (A and B) Bedside X-ray at 3 days after surgery; (C and D) X-ray at 2 weeks after surgery.
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case_images: Follow-up at six months showed significant improvement in pain, recovery of muscle strength to grade 5 in the right upper limb (Figure 4), and normalization of inflammatory markers.