•
Pyogenic: Staphylococcus aureus, Enterococccus, E Coli, Salmonella
•
Granulomatous infection: Tuberculous sponsylitis, fungal, parasitic
•
Different treatment
The causative organisms low rates of
isolation:
• 50% for tuberculous
•
60% - 80% for pyogenic
24-37% unknown source
Spondylodiskitis
- MR Findings
• MR
> CT
• Destruction of vertebral body
•
Destruction of cartilage
• Abscesses (bone,
soft tissue, epidural)
• Epidural flegmon
Erosions, osteitis, diskitis
| Erosions,
osteitis, diskitis
|
Epidural
phlegmon | 
Epidural
abscess |
•
Delay in diagnostic (clinical variability, lack of specificity)
•
Pain 7-28 dy after surgery
• 1/3 fever, 8%
superficial signs of infection
• MRI:
– High signal intensity disk
– Bone marrow edema
>>>
Postoperative
– Contrast enhancement
spondylodiskitis
SD
Boden, Radiology, 1992
Postoperative
Spondylodiskitis - MR Findings Early postopeartive diskitis MC
Chang et al, Spine 2006 – 33 TSd, 33 PSd
•
22 MR parameters were evaluated • 17 MR
parameter significantly differed between 2 groups | TB | P | | Bone destruction | 50%-75% | <50% | | Disk | Normal | Affected | | Abscess | Bone | Disk | | Enhancement vertebral body | Inhomogeneous | Homogenous | | Enhancement paraspinal | Well-defined | Ill-defined |
November 4,
2009
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