The value of MRI in the diagnosis of postoperative spondylodiscitis

Goethem, Johan Van; Parizel, Paul M.; Hauwe, Luc van den; Kelft, Erik Van de; Verlooy, Jan; Schepper, A. M. A. De

doi:10.1007/s002340000361

Cited by 74 publications

(29 citation statements)

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“…Finally, eight articles were excluded because the study samples were selected on the basis of the presence of VESC [41, 50,56,63,68,134,137,149]. In 9 of the remaining 77 original articles, a total of 21 study samples were investigated [24,35,36,49,74,76,78,102,145]. Seven of these represented specific LBP conditions and were excluded.…”

Section: Review Processmentioning

confidence: 99%

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

Jensen

Karppinen

Sorensen³

et al. 2008

Eur Spine J

391

297

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The prevalence of ''vertebral endplate signal changes'' (VESC) and its association with low back pain (LBP) varies greatly between studies. This wide range in reported prevalence rates and associations with LBP could be explained by differences in the definitions of VESC, LBP, or study sample. The objectives of this systematic critical review were to investigate the current literature in relation to the prevalence of VESC (including Modic changes) and the association with non-specific low back pain (LBP). The MEDLINE, EMBASE, and SveMED databases were searched for the period 1984 to November 2007. Included were the articles that reported the prevalence of VESC in non-LBP, general, working, and clinical populations. Included were also articles that investigated the association between VESC and LBP. Articles on specific LBP conditions were excluded. A checklist including items related to the research questions and overall quality of the articles was used for data collection and quality assessment. The reported prevalence rates were studied in relation to mean age, gender, study sample, year of publication, country of study, and quality score. To estimate the association between VESC and LBP, 2 9 2 tables were created to calculate the exact odds ratio (OR) with 95% confidence intervals. Eighty-two study samples from 77 original articles were identified and included in the analysis. The median of the reported prevalence rates for any type of VESC was 43% in patients with non-specific LBP and/or sciatica and 6% in non-clinical populations. The prevalence was positively associated with age and was negatively associated with the overall quality of the studies. A positive association between VESC and non-specific LBP was found in seven of ten studies from the general, working, and clinical populations with ORs from 2.0 to 19.9. This systematic review shows that VESC is a common MRI-finding in patients with non-specific LBP and is associated with pain. However, it should be noted that VESC may be present in individuals without LBP.

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Section: Review Processmentioning

confidence: 99%

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

Jensen

Karppinen

Sorensen³

et al. 2008

Eur Spine J

391

297

View full text Add to dashboard Cite

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“…18,19 Moreover, contrast enhancement in the disk and endplates may occur in both conditions. [18][19][20][21] However, because of desiccation and dehydration, the disk often appears normal or hypointense on T2WI in DDD, whereas its T2WI signal intensity is typically increased in spondylodiskitis. 18,19,21 Also, the vertebral endplates are usually preserved in DDD rather than eroded or destroyed as seen in disk space infection.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…18,21 Finally, the presence of paraspinal or epidural inflammation and/or collection should orient the diagnosis toward an infectious process. 18,20,21 In addition to these imaging considerations, the clinical presentation and context and the results of laboratory tests such as erythrocyte sedimentation rate and C-reactive protein (CRP) can help differentiate between the 2 entities. 18 In particular, the CRP appears to be a very reliable indicator of disk space infection, being raised in up to 100% of patients at the time of diagnosis.…”

Section: Differential Diagnosismentioning

confidence: 99%

The Modic Vertebral Endplate and Marrow Changes: Pathologic Significance and Relation to Low Back Pain and Segmental Instability of the Lumbar Spine

Rahme¹,

Moussa²

2008

AJNR Am J Neuroradiol

213

146

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SUMMARY:Two decades following their description, the significance of Modic vertebral endplate and marrow changes remains a matter of debate. These changes are closely related to the normal degenerative process affecting the lumbar spine, and their prevalence increases with age. However, the exact pathogenesis underlying these changes and their relation to segmental instability of the lumbar spine and to low back pain remain unclear. In this paper, we review the literature relevant to this topic and discuss the currently available evidence regarding the pathologic and clinical significance of Modic changes. Degenerative vertebral endplate and subchondral bone marrow changes were first noted on MR imaging by de Roos et al in 1987.1 A formal classification was subsequently provided by 2 based on a study of 474 patients, most of whom had chronic low back pain (LBP). These authors described 2 types of endplate and marrow changes:Type 1 changes (Fig 1) were hypointense on T1-weighted imaging (T1WI) and hyperintense on T2-weighted imaging (T2WI) and were shown to represent bone marrow edema and inflammation.Type 2 changes (Fig 2) were hyperintense on T1WI and isointense or slightly hyperintense on T2WI and were associated with conversion of normal red hemopoietic bone marrow into yellow fatty marrow as a result of marrow ischemia.

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“…It is reported that, with discitis, MRI shows decreased signal intensity in the area surrounding disk and vertebrae on T 1 WI and increased intensity on T 2 WI [12] . In our series, however, the presentation of 5 cases of postoperative discitis is not completely coincident with above-mentioned findings.…”

Section: Infectionmentioning

confidence: 98%

MRI manifestations and differentiated diagnosis of postoperative spinal complications

Yang

Wang

Luo

et al. 2009

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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To analyze MR manifestations of postoperative spinal complications and investigate the value of MRI in the diagnosis and differentiated diagnosis, 114 cases of spinal postoperative complications were analyzed retrospectively and compared with the clinical data. The results showed that the main postoperative spinal complications included spinal stenosis (n=33, consisting of 21 cases of epidural fibrosis and 12 cases of epidural hematoma or epidural abscess), lack of spinal stability (n=43), infection (n=23, consisting of 7 cases of para-spinal soft-tissue infection, 5 cases of vertebral discitis, 4 cases of vertebral and appendix infection, 3 cases of epidural abscess, 2 cases of myelitis, 2 cases of spinal arachnoiditis), others (n=28, consisting of 12 cases of inner fixation failure, 9 cases of epidural hematoma, 7 cases of cerebrospinal fluid gusher). It is concluded that MRI can specifically display all kinds of postoperative spinal complications, and is of significant value in the diagnosis and differentiated diagnosis of postoperative spinal complications.

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The value of MRI in the diagnosis of postoperative spondylodiscitis

Cited by 74 publications

References 0 publications

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

The Modic Vertebral Endplate and Marrow Changes: Pathologic Significance and Relation to Low Back Pain and Segmental Instability of the Lumbar Spine

MRI manifestations and differentiated diagnosis of postoperative spinal complications

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