Magnetic resonance imaging characteristics of tuberculous spondylitis vs. pyogenic spondylitis

Harada, Yasuhiro; Tokuda, Osamu; Matsunaga, Naofumi

doi:10.1016/j.clinimag.2007.03.015

Cited by 56 publications

(56 citation statements)

References 12 publications

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“…MRI is one of the most important examination techniques to diagnose pyogenic spondylitis 16,17) . Regarding the diagnosis of the pyogenic spondylitis, it has been shown that the sensitivity was 96% and the specificity was 92% by using MRI 18) .…”

Section: Discussionmentioning

confidence: 99%

Predictors of conservative treatment for pyogenic spondylitis

Kugimiya

Muraki

Nagakura

et al. 2017

Spine Surg Relat Res

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Abstract:Introduction: Although initial treatments for pyogenic spondylitis include conservative approaches such as rest and antibiotics, some cases are refractory to conservative therapy. The objective of this study was to clarify the predictors for achievement of C-reactive protein (CRP) normalization in pyogenic spondylitis by conservative therapy.Methods: In the present study, we enrolled 83 patients (51 men and 32 women) with conservatively treated pyogenic spondylitis from 2006 to 2015. Multiple logistic regression analysis was used to examine the association of achievement of CRP normalization with the number of infected vertebrae, bacterial strain, blood data, and the expansion of abscess to the epidural space by using functional magnetic resonance imaging.Results: We found significant differences in the subjects with and without achievement of CRP normalization with respect to age, the number of affected vertebrae, ratio of resistant pathogenic bacteria, ratio of expansion of abscess to the epidural space, and blood data such as Hb, ALB, eGFR, Cr, and ALP levels.After adjustment for age and sex, the number of infected vertebral bodies, resistant bacteria, expansion of abscess to the epidural space, and Hb level showed significant associations with the normalization of CRP. In addition, we used multiple logistic regression analysis with age, sex, number of infected vertebral bodies, resistant bacteria, expansion of abscess to the epidural space, and serum Hb level as explanatory variables. We found that expansion of the abscess to the epidural and paravertebral spaces was significantly associated with the normalization of CRP level.Conclusions: The number of infected vertebral bodies, resistant strains of pathogenic bacteria, expansion of abscess to the epidural and paravertebral spaces, and serum Hb level predicts the prognosis of patients with pyogenic spondylitis. Particularly, expansion of abscess to the epidural and paravertebral spaces was strongly associated with the achievement of CRP normalization.

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Section: Discussionmentioning

confidence: 99%

Predictors of conservative treatment for pyogenic spondylitis

Kugimiya

Muraki

Nagakura

et al. 2017

Spine Surg Relat Res

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“…Bone and joint TB may account for 15-35% of patients with extrapulmonary TB [7]. Spinal TB, traditionally referred to Pott's disease, accounting for 25-60% of all osseous infections caused by tuberculosis [8,9]. Most cases of spinal TB involved the thoracic and lumbar regions, and the cervical spine involved at a rate fewer than 5% [10].…”

Section: Discussionmentioning

confidence: 99%

Isolated extradural tuberculous granuloma of the cervical spine: a case report

et al. 2011

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Introduction Isolated intraspinal extradural tuberculous granuloma (IETG) without radiological evidence of vertebral involvement is uncommon, especially rare in cervical spine. Materials and methods We report a case of cervical IETG without bone involvement in a patient with neurological deficit. The patient suffered from progressive neurological dysfunction. MRI of cervical spine revealed an intraspinal extradural mass, and the spinal cord was edematous because of the compression. Thus C2-C4 laminectomy was performed and extradural mass was excised. Results The excised extradural mass was confirmed to be tuberculous granuloma through pathologic examination. Antituberculous drugs were administrated with a regular follow-up. Excellent clinical outcomes were achieved. Conclusions The isolated IETG, although a rare entity, should be considered in the differential diagnosis of the intraspinal mass, especially in patients with spinal cord compression and a history of tuberculosis. If there is a progressing neurological deficit, a combination of surgical and anti-tuberculous treatment should be the optimal choice.

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“…They concluded that MR imaging is useful in differentiation of TB spondylitis from pyogenic spondylitis 9 .…”

Section: Resultsmentioning

confidence: 99%