Background: To evaluate the efficacy of unilateral biportal endoscopy (UBE) following radiotherapy in patients with short-segment lumbar Brucella spondylitis (LBS). Materials and Methods: A retrospective analysis was performed on 45 patients with LBS treated between January 2020 and January 2022. All patients underwent radiotherapy as an adjunct to standardized anti-Brucella pharmacological therapy before surgical intervention. Radiotherapy was delivered to the affected lumbar region with a fractionated dose of 30–40 Gy (2 Gy per fraction, 5 fractions per week), aimed at controlling local infection and reducing inflammatory granulomas. Patients were subsequently assigned to two groups: UBE (n=21) or posterior lumbar interbody fusion (PLIF, n=24). Clinical outcomes were compared using operative time, intraoperative blood loss, hospitalization duration, visual analog scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) score, inflammatory markers (CRP, ESR), neurological recovery, and complication rates. Results: Compared with PLIF, the UBE group demonstrated significantly shorter operative times (136.1±31.6 vs. 178.5±33.5 min, P<0.01), less blood loss (223.7±160.2 vs. 434.4±230.8 mL, P<0.01), and reduced hospitalization (12.2±7.6 vs. 15.6±4.1 days, P=0.028). Both groups showed marked postoperative improvements in VAS, ODI, JOA, CRP, and ESR, with normalization of inflammatory markers at 6 months. Neurological improvement exceeded 79% in both groups. Although not statistically significant, complication rates were lower with UBE (4.8% vs. 12.5%). Conclusion: Radiotherapy combined with UBE provides effective infection control and functional recovery in LBS, with advantages in reduced surgical trauma, faster recovery, and comparable long-term outcomes to PLIF. |
