Abstract
Magnetic Resonance Imaging is the imaging modality of choice for imaging spinal infection due to its high sensitivity and specificity. This study aims to study the magnetic resonance imaging changes in patients with spondylodiscitis. The study was a retrospective study carried in a multimodality imaging centre in Kathmandu. Magnetic resonance imaging records and clinical record of 3 years duration were reviewed and patients with clinical and radiological diagnosis of spondylodiscitis were included in the study. Three radiologists interpreted Magnetic Resonance Imaging with mutual consensus in disputed issues. Data analysis was done with Statistical Package for Social Sciences21.0. A total of 52 patients were included in the study. The mean age of the patients was 43.9 ± 17.6 years. Spondylodiscitis involved lumbar spine in 26(50%) case, cervical and thoracic spine in 13(25%) cases each. Multiple IV discs were involved in 24(46.2%) cases, which was most common in cervical spine and least common in thoracic spine. Only one vertebral end plate was involved in 16(30.8%) cases. Epidural collection was seen in 23(44.2%) cases and paravertebral collection was noted in 63(33.5%) cases. Statistical significant difference in region of spine involved (p=0.02) and epidural collection (p=0.04) was noted between genders. Lumbar spine was the most common level involved with spondylodiscitis, perivertebral enhancing soft tissue was present in all cases, and involvement of disc and the endplates were the most common pattern.
Highlights
Infection of the spine accounts for 2-4% of all skeletal infection.[1]
Magnetic Resonance Imaging (MRI) due to its multi plananr capabilities, excellent soft tissue contrast and simultaneous visualization of neural elements is the modality of choice for imaging of spinal infection.[4]
On MRI conditions like degenerative vertebral changes (Modic changes)[5] spondyloarthropathies may be mistaken for spondylodiscitis
Summary
Infection of the spine accounts for 2-4% of all skeletal infection.[1]. Spondylodiscitis involves intervertebral disc and its adjacent vertebral bodies but later may extend into the perispinal region, epidural region and over several spinal segments. The area has relatively restricted access to aspiration and culture and imaging guidance is required for obtaining the material. In this context, imaging remains the main stay of diagnosis, localization and follow up.[2,3] Magnetic Resonance Imaging (MRI) due to its multi plananr capabilities, excellent soft tissue contrast and simultaneous visualization of neural elements is the modality of choice for imaging of spinal infection.[4] on MRI conditions like degenerative vertebral changes (Modic changes)[5] spondyloarthropathies may be mistaken for spondylodiscitis. Findings like disc changes: T2 hyperintensity, loss of nuclear cleft, decreased disc height, erosion and destruction of endplates, and perivertebral and epidural soft tissue edema are more favorable to infective spondylodiscitis.[6]. This study aims to study the magnetic resonance imaging changes in patients with spondylodiscitis
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