Isolated Tuberculosis of Posterior Elements of Spine

Narlawar, Ranjeet; Shah, Jeshil R.; Pimple, M.; Patkar, Deepak; Patankar, Tufail; Castillo, Maurício

doi:10.1097/00007632-200202010-00015

Cited by 64 publications

(21 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although not specific to spinal TB, there is a decrease in signal intensity of the involved bone and soft tissues on T2-weighted images and the increase in intensity of a uniform thin rim enhancement is a pathogenomic finding suggesting either caseation necrosis or a cold abscess in tuberculosis [16]. In the evaluation of spinal TB with isolated involvement of the posterior elements, MRI is also useful in diagnosis and assessment of the treatment response [17]. …”

Section: Diagnosismentioning

confidence: 99%

Spinal Tuberculosis: Diagnosis and Management

et al. 2012

View full text Add to dashboard Cite

The spinal column is involved in less than 1% of all cases of tuberculosis (TB). Spinal TB is a very dangerous type of skeletal TB as it can be associated with neurologic deficit due to compression of adjacent neural structures and significant spinal deformity. Therefore, early diagnosis and management of spinal TB has special importance in preventing these serious complications. In order to extract current trends in diagnosis and medical or surgical treatment of spinal TB we performed a narrative review with analysis of all the articles available for us which were published between 1990 and 2011. Althoug h the development of more accurate imaging modalities such as magnetic resonance imaging and advanced surgical techniques have made the early diagnosis and management of spinal TB much easier, these are still very challenging topics. In this review we aim to discuss the diagnosis and management of spinal TB based on studies with acceptable design, clearly explained results and justifiable conclusions.

show abstract

Section: Diagnosismentioning

confidence: 99%

Spinal Tuberculosis: Diagnosis and Management

et al. 2012

View full text Add to dashboard Cite

show abstract

“…[456789] Lower thoracic and lumbar vertebrae are the most common sites of spinal TB followed by middle thoracic and cervical vertebrae. [7101112131415] The second cervical to seventh cervical region is reportedly involved in 3-5% of cases and atlantoaxial articulation is less than 1% cases. In TB, involvement of posterior elements due to TB is not so uncommon.…”

Section: Introductionmentioning

confidence: 99%

“…The lamina was most commonly involved followed by pedicles, articular processes, spinous processes, and transverse processes. [4567111216]…”

Section: Introductionmentioning

confidence: 99%

Pott′s spine: Diagnostic imaging modalities and technology advancements

et al. 2013

View full text Add to dashboard Cite

Spinal tuberculosis (TB) or Pott's spine is the commonest extrapulmonary manifestation of TB. It spreads through hematogenous route. Clinically, it presents with constitutional symptoms, back pain, tenderness, paraplegia or paraparesis, and kyphotic or scoliotic deformities. Pott's spine accounts for 2% of all cases of TB, 15% of extrapulmonary, and 50% of skeletal TB. The paradiscal, central, anterior subligamentous, and neural arch are the common vertebral lesions. Thoracic vertebrae are commonly affected followed by lumbar and cervical vertebrae. Plain radiographs are usually the initial investigation in spinal TB. For a radiolucent lesion to be apparent on a plain radiograph there should be 30% of bone mineral loss. Computed tomographic scanning provides much better bony detail of irregular lytic lesions, sclerosis, disc collapse, and disruption of bone circumference than plain radiograph. Magnetic resonance imaging (MRI) is the best diagnostic modality for Pott's spine and is more sensitive than other modalities. MRI frequently demonstrates disc collapse/destruction, cold abscess, vertebral wedging/collapse, marrow edema, and spinal deformities. Ultrasound and computed tomographic guided needle aspiration or biopsy is the technique for early histopathological diagnosis. Recently, the coexistence of human immunodeficiency virus infections and TB has been increased globally. In recent years, diffusion-weighted MRI (DW-MRI) and apparent diffusion coefficient values in combination with MRI are used to some extent in the diagnosis of spinal TB. We have reviewed related literature through internet. The terms searched on Google scholar and PubMed are TB, extrapulmonary TB, skeletal TB, spinal TB, Pott's spine, Pott's paraplegia, MRI, and computed tomography (CT).

show abstract

“…Associated posterior element involvement had been reported between 8% and 68%. [1422232728] On MR imaging, 109 vertebrae were involved in the study population comprising fifty patients. The average number of vertebrae affected per patients was 2.18.…”

Section: Discussionmentioning

confidence: 99%

“…[15] Various authors have reported incidence of endplate erosions between 25% to 100%. [4613152728] Out of the total 62 discs at initial presentation; 53 showed discitis, 5 were spared, and 4 were destroyed. The reported incidence of disc involvement varies from 33% to 100%.…”

Section: Discussionmentioning

confidence: 99%

Clinicoradiologic profile of involvement and healing in tuberculosis of the spine

Singh¹,

Magu²,

Rk³

2016

Ann Med Health Sci Res

View full text Add to dashboard Cite

Background:There is no much information about how tuberculous lesions of the spine progress/heal; what clinical and radiological features suggest progression/healing; what is the optimal duration of antitubercular treatment; and what clinical, laboratory, and radiological investigations and their frequency should be done to monitor the disease course.Aims:The present study aimed to evaluate what specific clinicoradiologic features suggest involvement and healing in tuberculosis of the spine.Subjects and Methods:Fifty spinal tuberculosis patients (30 males and 20 females) diagnosed clinicoradiologically were enrolled in the study. Patients were evaluated clinically, radiographically, and by magnetic resonance imaging (MRI) at regular intervals to monitor the disease course till 24 months of the initial presentation.Results:Wedge/collapse (23/50 cases), soft tissue mass (29/50 cases), disc narrowing (45/54 discs), and endplate erosions (89/107 endplates) were the plain radiological findings of tubercular spinal involvement. Earliest sign of healing on plain radiography was decrease in fuzziness of endplate, ultimately leading to either sclerosis of endplate or fusion of adjacent vertebrae. Initial MRI findings included bone marrow edema (50/50 cases), discitis (53/62 discs), endplate erosions (105/123 endplates), pre- and para-vertebral collections (45/50 cases), epidural involvement (26/50 cases), epidural spread (77/109 vertebrae), and subligamentous spread (42/50 cases). Earliest feature of healing on magnetic resonance (MR) examination was decrease in inflammatory soft-tissue masses and reduction in marrow edema.Conclusions:Salient features of spinal involvement in tuberculosis on plain radiograph were paradiscal involvement, endplate destruction, and soft tissue masses. Marrow edema, paravertebral collections, subligamentous spread, extradural component, endplate erosion, and discitis suggested tubercular involvement of the spine on MRI. A decrease in these was observed to have prognostic value both in monitoring disease course and response to chemotherapy. Based on the clinicoradiologic findings of the present study, we propose decision-making algorithm, follow-up algorithm, and MR examination protocol for spinal tuberculosis.Level of evidence:This was a Level II study.

show abstract

Isolated Tuberculosis of Posterior Elements of Spine

Abstract: In tuberculosis of the posterior element of the spine, MRI is extremely useful in evaluating the extent of involvement and response to therapy of isolated tuberculosis of posterior elements. Involvement of posterior elements due to tuberculosis is not so uncommon.

Cited by 64 publications

References 12 publications

Spinal Tuberculosis: Diagnosis and Management

Spinal Tuberculosis: Diagnosis and Management

Pott′s spine: Diagnostic imaging modalities and technology advancements

Clinicoradiologic profile of involvement and healing in tuberculosis of the spine

Contact Info

Product

Resources

About