Introduction: Brucellosis is an endemic disease especially in Middle East and Meditation region. Saudi Arabia had the highest incidence rate in the middle east until late 1990s when the government started aggressive eradicate programme . In spite of this efforts ministry of health register more than 37000 case between 2004 and 2012.

Methods: This is A retrospective study conducted in King Abdulaziz Medical City, Riyadh, Saudi Arabia. Eighty patients with spinal brucellosis during a period of 8 years (2008–2015) were included. Diagnosis was based on clinical presentation, laboratory findings, radiographic evidence. The Brucellar etiology was considered when seroagglutination tests were positive at a titer of 1/160 or higher, and/or Brucella spp were isolated in the blood or sample cultures.

Results: The mean age of patients was 58.1 years (60 males, 20 females). Back or neck pain (90% of patients), fever (75%), and sweats (45%) were the most common symptoms. Cultures of blood specimens from twenty patients (25%) were positive for Brucella. Twenty patients (25%) had motor weakness or paralysis. Epidural masses, paravertebral masses and psoas abscesses were detected in 80%, 70% and 35% of patients, respectively. The lumbar vertebra was the most frequently involved region with 68 cases (85%), followed by 4 cases in the thoracic (5%), 4 cases cervical (5%) and 4 cases in lumbosacral (5%) segments. There were no deaths or severe deterioration in this study.

Conclusions: Brucellar spondylitis should be considered in patients with back pain and fever in Saudi Arabia. Clinical presentation, laboratory finding, and radiological examinations help to confirm the diagnosis of spine involvement.

Patient Care: Up to our knowledge no study was publish from Saudi Arabia except sporadic case reports, in spite of high number of cases.this study will enhance early detection and diagnosis of spinal brucellosis. Therefore, early management and better outcome. This study was approve by King Abdullah International Medical Research Center (KAIMRC) with No. RC16/048/R

Learning Objectives: 1. The clinical presentation of spin brucellosis. 2. Radiological appearance of spin brucellosis. 3. Type of management of these patient and the duration. 4. The outcome of spine brucellosis.

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