A Review On: Spinal Cord Infections (original) (raw)
Related papers
Spinal and spinal cord infection
European radiology, 2004
This review article includes infections of the vertebral body, intervertebral disc, ligaments and paravertebral soft tissues, epidural space, meninges and subarachnoid space, and the spinal cord. A wide range of infective organisms may be implicated and the incidence of some, notably tuberculosis, is rising due to increased immunocompromise and other factors. Imaging plays a key role in early diagnosis of these diseases, which may be severe and potentially life threatening. Infection may be acquired by the hematogenous route, by infection from contiguous structures or from direct inoculation. Of available imaging techniques, CT and MRI offer the clinically most valuable methods of evaluating all the structures potentially involved in infection. Although many signs are non-specific, indication is given of where appearances raise strong suspicion of infection. The extent of the inflammatory process is well evaluated by imaging, particularly in terms of severity and morbidity of clinic...
Radiology of Infectious Diseases, 2016
Infection involving the vertebral column, including the bone, intervertebral disk, and paravertebral soft tissues is critical and early diagnosis and directed treatment is paramount. Different infectious organisms present with variable imaging characteristics, which when examined in conjunction with the clinical history, can facilitate early diagnosis and treatment and ultimately prevent patient morbidity and mortality. This article discusses the pathophysiology of infection of the vertebral column, as well as the imaging findings of bacterial, tuberculous, and fungal spondylitis/spondylodiskitis. We review the imaging findings utilizing plain radiography, computed tomography, and magnetic resonance imaging, as well as a discussion regarding advanced imaging techniques.
The Imaging of Spinal Infections
Seminars in Spine Surgery, 2007
Spinal infections can arise in a variety of anatomical locations and structures and encompass vertebral osteomyelitis, discitis, disc space infection, epidural abscesses, and infection of the adjacent soft tissue structures. Plain radiography, computed tomography, magnetic resonance imaging (MRI), and nuclear imaging all have a role in the diagnosis of spinal infection. MRI continues to be the gold standard for the imaging diagnosis of spinal infections. 67 Gallium citrate and Tc-99m-methylene diphosphonate scintigraphy have become the standard for nuclear imaging of the spine. Fluorine-18-fluorodeoxyglucose positron emission tomography, strepavidin/ 111 In-biotin, and 99m -ciprofloxacin have shown promise for aiding in the diagnosis and evaluation of spinal infection but warrant further study. Semin Spine Surg 19:106-112.
Spinal tuberculosis: imaging features on MRI
International Journal of Medical Research and Review, 2018
Introduction: Spine is the most common site of skeletal tuberculosis.Radiographic manifestations of tuberculous spondylitis include intraosseous and paraspinal abscess formation, subligamentous spread of infection, vertebral body destruction and collapse, and extension into the spinal epidural space. Significant instability and deformity of the spine can result, mandating prompt diagnosis and treatment to prevent permanent neurologic damage. Objective: This is a prospective and descriptive study to evaluate the role of MRI in spinal tuberculosis and various spectrum ofits manifestations. Materials and Methods: This prospective study was on 25 patients of either age or sex with clinical suspicion of spinal TB over a period of 2 years and subsequently went MR Imaging and features were correlated with other investigations and histopathological diagnosis in few patients. Results: Thoracic spine was the most common site of involvement. Vertebral body wedge collapse or compression fracture was seen in 64% of patients. Posterior element involvement was found in 10 out of 25 cases. Prevertebral & paravertebral collections were seen in 88% of cases. Epidural soft tissue component was seen in 56% of cases. Conclusion: MRI is the best diagnostic modality for spinal TB and to demonstratethe various associated manifestations which help in assessing the extent and severity of the disease and thus inearly and correct management planning.
Tuberculosis of the spine and spinal cord
European Journal of Radiology, 2005
Tuberculosis remains an important problem in underdeveloped countries, especially in individuals under the age of 20 years. In developed countries, there was an increase of the disease due to several factors, especially the appearance of A.I.D.S. The arterial haematogenous seeding is the most important way to the propagation of the disease to the rachis. The bacillus mycobacterium tuberculosis is characterized by a slow growth, propention for an oxygen rich environment and the absence of proteolytic enzymes. These characteristics are responsible for the imaging particularities of tuberculous osteomyelitis. The diagnosis can be confirmed by the bacteriologic and histological studies from samples removed by punction biopsy.
Assessment of imaging finding in Spinal tuberculosis
Journal of Medical Science And clinical Research, 2019
Introduction: Involvement of spine in tuberculosis is most common skeletal manifestation of extra-pulmonary tuberculosis. It is a destructive process involving abscess, collapse of vertebra, end plate irregularities, cord abnormalities and intervertebral disc deformity. X-ray always remains initial imaging modality of choice followed by CT and MRI. Most commonly followed path of assessment includes X-ray and MRI, as bony abnormalities seen best on X-ray and soft tissue abnormalities on MRI. Present study was performed to assess imaging findings in spinal tuberculosis using X-ray and MRI. Method and Materials: The study was conducted on 50 patients clinically suspected of spinal tuberculosis referred to radiology department for further workup. After taking an informed and written consent, X-ray was taken first, followed by MRI. Results: Back pain is most common symptom of Spinal TB. Kyphosis, scoliosis, collapse of vertebra, cord edema, involvement of disc, abscess, canal stenosis, reduced bone density and thecal sac indentation were the findings seen in spinal tuberculosis patients. MRI was noted to be a better modality for the evaluation of the canal abnormalities and extent of abscess. Conclusion: X-ray remains initial imaging modality due to easily available cheap modality and excellent demonstration of bony abnormalities. However, MRI remains best available modality due to its excellent soft tissue demonstration and marrow lesions.
IOSR Journals , 2019
Background:MRI is now the preferred imaging modality and preferred technique to define the activity and extent of infection for patients with suspected spinal tuberculosis. The objective of the study was to describe diagnostic accuracy, sensitivity and specificity of MRI in diagnosis of spinal tuberculosis and various radiological features of spinal tuberculosis (TB) on magnetic resonance imaging (MRI). Methods:Out of total 55 cases of suspected tuberculosis in our study we given 45 case as spinal spondylodiscitis out of which 43 cases accurately diagnosed by MRI proved by histopathology or culture reports. And 10 cases of given non tubercular out of which 1 case came to be tubercular spondylodiscitis on histopathology. MRI case records of these 44 patients with proven tuberculosis retrospectively analysed. Results: The majority of the 44 patients were males 60% and most common age group is 31 to 50 years age group (50%). The most common clinical presentation was backache 79.55% (n=35) followed by fever 26/44 cases (59.09%). The Thoraco-lumbar spine was the commonest site of the disease (38.64%) followed by the lumbar region (31.82%). An intervertebral disc involvement, pre and paravertebral collections, subligamental extension of the abscess were commonly seen, with an epidural collection occurring in more than 75 % of the cases. In addition few cases also showed single vertebral involvement (n-3) and few cases shows skip lesions. Conclusions: The MRI scan is highly sensitive in the detection of various pathological processes of spinal tuberculosis and their pattern of occurrence. The extent of soft tissue involvement disease is best assessed by MRI which help in guiding the surgical treatment as well as to monitor the response to treatment during follow up.
Imaging of Spinal Tuberculosis
Imaging of Spinal Infection, 2021
Spinal tuberculosis represents 25-60% of all musculoskeletal tuberculosis. It remains frequent in low-and middle-income countries, and an increased incidence of infections has been recently observed in developed countries. Three main anatomico-radiological patterns have been described, namely, tuberculous spondylodiscitis (also called Pott disease), isolated tuberculous vertebral osteomyelitis, and primitive neural arch tuberculosis. Magnetic resonance imaging allows an early diagnosis of spinal tuberculosis. In the absence of early and adequate treatment, tuberculosis progresses and may lead to spinal deformities and/or neurological complications. A positive diagnosis is usually straightforward when the patient already has an existing extra-skeletal tuberculosis. Otherwise, spinal tuberculosis is typically confirmed by bacteriological and/or histopathological tests. Abbreviations CT Computed tomography MRI Magnetic resonance imaging TB Tuberculosis
Spinal tuberculosis: MRI findings in a case series of 35 patients
GSC Advanced Research and Reviews
Tuberculosis (TB) remains a major health burden worldwide. Ten million people were diagnosed with TB in 2020. With 1.5 million deaths in 2020, TB is the 13th cause of mortality and the second most common cause of infectious deaths, preceded only by COVID-19. The vast majority of cases are reported from low- and middle-income countries. MRI of the spine is a reliable tool for the diagnosis of TB spondylitis. Findings such as involvement of the endplates and vertebral body, thoracic spine, para-spinal collection and psoas abscesses and relative sparing of the intervertebral disc are highly suggestive of spinal TB rather than other diagnoses. Combined with Gene Xpert tests, MRI can render very high diagnostic accuracy. This is essential for early detection of tuberculous disease of the spine and timely initiation of medical treatmen. We present a series of 35 patients with typical MRI findings of spinal tuberculosis.
Spinal Intramedullary Tuberculosis
The Surgery Journal
Tuberculosis of the central nervous system accounts for approximately 1% of all cases of tuberculosis and 50% of these involve the spine. Intramedullary involvement is rare in tuberculosis. Clinical presentation of spinal intramedullary tuberculosis (SIMT) is similar to intramedullary spinal cord tumor. Here, we report the case of a 49-year-old female with dull aching pain of both upper limbs of 1-week duration. On examination, she had no motor deficits. All the deep tendon reflexes were normal. The plantar responses were flexor bilaterally. Cervical spine imaging favored intramedullary tumor. She had partial relief of symptoms with steroid treatment. Repeat imaging done 1 month later revealed mild interval enlargement of the intramedullary lesions and multiple enlarged mediastinal and hilar nodes. Endoscopic ultrasound-guided fine-needle aspiration cytology of mediastinal nodes was suggestive of granulomatous inflammation. Hence, SIMT was considered as the probable diagnosis. The p...