Pedicle involvement in tuberculous spondylitis and pyogenic spondylitis: Comparative magnetic resonance imaging study

Abstract

AimMagnetic resonance imaging (MRI) comparison of the pedicle involvement in TB spondylitis and pyogenic spondylitis in relation to degree of spinal deformity, degree of vertebral body and disc damage and paravertebral and epidural abscess formation. Materials and methodsMRIs of 38 patients who had been diagnosed with and treated for spinal infection, 22 patients for TB spondylitis and 16 patients for pyogenic spondylitis were retrospectively evaluated for pedicle involvement, degree of spinal deformity, vertebral body and disc damage and paravertebral and epidural abscess formation. ResultsIncidence of pedicle involvement was highly significant more in TB spondylitis than in pyogenic spondylitis (P value <0.01). Incidence of vertebral body collapse in vertebral bodies with pedicle involvement was equal in both groups, however more than 50% vertebral body collapse only reported in TB spondylitis (P value=0.0001). Kyphotic deformity was reported only in TB spondylitis. There was no significant difference in disc damage, paravertebral or epidural abscess formation between both groups. ConclusionPedicle involvement is a common MRI finding in TB spondylitis, and significantly less common in pyogenic spondylitis. Kyphotic deformity and advanced degree of vertebral body collapse might play a significant role in pedicle involvement in cases of spinal infection.