Update on Imaging of Spinal Fixation Hardware

Winegar, Blair A.; Kay, Marguerite M. B.; Chadaz, Tyson S.; Taljanovic, Mihra S.; Hood, Kenneth A.; Hunter, Tim B.

doi:10.1055/s-0038-1677468

Cited by 20 publications

(9 citation statements)

References 92 publications

(91 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the instrumented spine, infection usually results in discitis/osteomyelitis, with low T1W signal intensity, high fluid signal intensity, and contrast enhancement within the intervertebral space and adjacent vertebral marrow. Adjacent inflammatory and infectious changes such as enhancing paraspinal or epidural phlegmon or rim-enhancing abscess formation may occur ( Figures 11, 13, 14 ) [ 96 ].…”

Section: Surgical Hardware Infectionsmentioning

confidence: 99%

Magnetic resonance imaging of musculoskeletal infections

Weaver¹,

Omar²,

Mar³

et al. 2022

Pol J Radiol

Self Cite

View full text Add to dashboard Cite

Magnetic resonance imaging (MRI) is a powerful imaging modality in the evaluation of musculoskeletal (MSK) soft tissue, joint, and bone infections. It allows prompt diagnosis and assessment of the extent of disease, which permits timely treatment to optimize long-term clinical outcomes. MRI is highly sensitive and specific in detecting the common findings of MSK infections, such as superficial and deep soft tissue oedema, joint, bursal and tendon sheath effusions, lymphadenopathy, bone marrow oedema, erosive bone changes and periostitis, and bone and cartilage destruction and sequestration. Contrast-enhanced MRI allows detection of non-enhancing fluid collections and necrotic tissues, rim-enhancing abscesses, heterogeneously or diffusely enhancing phlegmons, and enhancing active synovitis. Diffusion-weighted imaging (DWI) is useful in detecting soft-tissue abscesses, particularly in patients who cannot receive gadolinium-based intravenous contrast. MRI is less sensitive than computed tomography (CT) in detecting soft-tissue gas. This article describes the pathophysiology of pyogenic MSK infections, including the route of contamination and common causative organisms, typical MR imaging findings of various soft tissue infections including cellulitis, superficial and deep fasciitis and necrotizing fasciitis, pyomyositis, infectious bursitis, infectious tenosynovitis, and infectious lymphadenitis, and of joint and bone infections including septic arthritis and osteomyelitis (acute, subacute, and chronic). The authors also discuss MRI findings and pitfalls related to infected hardware and diabetic foot infections, and briefly review standards of treatment of various pyogenic MSK infections.

show abstract

Section: Surgical Hardware Infectionsmentioning

confidence: 99%

Magnetic resonance imaging of musculoskeletal infections

Weaver¹,

Omar²,

Mar³

et al. 2022

Pol J Radiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…After 6 to 9 months, these are the three main fusion criteria for antero- or posterolateral arthrodesis 42 :…”

Section: Lumbar Spondylolisthesismentioning

confidence: 99%

Lumbar Spine Posttherapeutic Imaging

Lacroix

Ferrero

Burns

et al. 2022

Semin Musculoskelet Radiol

View full text Add to dashboard Cite

Management of patients after lumbar spine surgery or interventional radiology can be complex, and postoperative imaging patterns are often poorly understood by nonspecialized radiologists. This article focuses on postoperative imaging features of the lumbar spine in five clinical settings (with corresponding interventions): vertebral osteoporotic fractures (percutaneous vertebroplasty and vertebral augmentation), lumbar disk herniation (surgical diskectomy and percutaneous interventional radiology), lumbar spinal stenosis (surgical decompression), lumbar spondylolisthesis (surgical decompression and fusion), and degenerative scoliosis (techniques of osteotomies).For each intervention, we discuss imaging indications, depending if the patient is asymptomatic or if there are suspected complications, describe normal and pathologic imaging features, and present key points.

show abstract

“…Here starts a vicious cycle, in which loosening increases movement, which promotes further bone 15 BioMed Research International resorption and finally screw pullout or vertebral fractures. On conventional radiography and CT, the loose material is identified as a lucent halo or rim around the perimeter of screws or plates > 2 mm; every evaluation must be compared with previous imaging [6,80,81]. Figure 16 shows radiography of the lumbar spine with resorption of bone in the vertebral body of L5 leading to hardware loosening.…”

Section: Late Complicationsmentioning

confidence: 99%

“…If the tip of the edges of the instrumentation hardware is prominent, this can lead to chronic inflammation, pain, and even necrosis of the adjacent tissue; in this scenario, the removal of synthesis material is indicated [ 80 ]. Screw fractures can be detected on conventional radiographs, but the detection of fractures can be challenging when there is no displacement of the fractured components; CT offers the best visualization of hardware despite artifacts produced because each instrument can be scrutinized in multiple planes and without overlap [ 81 ].…”

Section: Classification Of Postoperative Spine Complicationsmentioning

confidence: 99%

“…(3) Implant Migration . When biomechanics of the spine are locally modified due to hardware loosening, infection, or malignancy, screws and rods and cages can migrate from their position, resulting in damage to adjacent tissue or piercing essential structures [ 81 ]. To evidence implant migration, plain radiographs and CT are the best imaging choice [ 83 ].…”

Section: Classification Of Postoperative Spine Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Imaging Assessment of the Postoperative Spine: An Updated Pictorial Review of Selected Complications

Corona-Cedillo

Saavedra-Navarrete

Espinoza-Garcia

et al. 2021

BioMed Research International

View full text Add to dashboard Cite

Imaging of the postoperative spine requires the identification of several critical points by the radiologist to be written in the medical report: condition of the underlying cortical and cancellous bone, intervertebral disc, and musculoskeletal tissues; location and integrity of surgical implants; evaluation of the success of decompression procedures; delineation of fusion status; and identification of complications. This article presents a pictorial narrative review of the most common findings observed in noninstrumented and instrumented postoperative spines. Complications in the noninstrumented spine were grouped in early (hematomas, pseudomeningocele, and postoperative spine infection) and late findings (arachnoiditis, radiculitis, recurrent disc herniation, spinal stenosis, and textiloma). Complications in the instrumented spine were also sorted in early (hardware fractures) and late findings (adjacent segment disease, hardware loosening, and implant migration). This review also includes a short description of the most used diagnostic techniques in postoperative spine imaging: plain radiography, ultrasound (US), computed tomography (CT), magnetic resonance (MR), and nuclear medicine. Imaging of the postoperative spine remained a challenging task in the early identification of complications and abnormal healing process. It is crucial to consider the advantages and disadvantages of the imaging modalities to choose those that provide more accurate spinal status information during the follow-up. Our review is directed to all health professionals dealing with the assessment and care of the postoperative spine.

show abstract

Update on Imaging of Spinal Fixation Hardware

Cited by 20 publications

References 92 publications

Magnetic resonance imaging of musculoskeletal infections

Magnetic resonance imaging of musculoskeletal infections

Lumbar Spine Posttherapeutic Imaging

Imaging Assessment of the Postoperative Spine: An Updated Pictorial Review of Selected Complications

Contact Info

Product

Resources

About