Neuroimaging clinics of North America
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Spinal infections are a spectrum of disease comprising spondylitis, diskitis, spondylodiskitis, pyogenic facet arthropathy, epidural infections, meningitis, polyradiculopathy, and myelitis. Inflammation can be caused by pyogenic, granulomatous, autoimmune, idiopathic, and iatrogenic conditions. ⋯ Despite advanced diagnostic technology, diagnosis of this entity and differentiation from degenerative disease, noninfective inflammatory lesions, and spinal neoplasms are difficult. Radiological evaluations play an important role, with contrast-enhanced MR imaging the modality of choice in diagnosis, evaluation, treatment planning, interventional treatment, and treatment monitoring of spinal infections.
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The imaging features of spinal parasitic diseases and other rare infections are herein discussed. These diseases are distributed worldwide, with increased prevalence in areas with poor sanitary conditions and in developing countries. ⋯ Infectious diseases are usually treatable, and early detection is often crucial. A thorough comprehension of the imaging patterns associated with the clinical features, epidemiology, and laboratory results allows the radiologist to narrow down the options for differential diagnosis and facilitates the timely implementation of appropriate therapies.
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Neuroimaging Clin. N. Am. · May 2015
Review Case ReportsImage guided interventions in spinal infections.
Spinal infections are challenging to diagnose and represent a life-threatening medical condition. Diagnosis is often delayed because of nonspecific accompanying symptoms. The role of interventional neuroradiology in spinal infection is double: diagnostic and therapeutic, consisting substantially of 2 main procedures, represented by spine biopsies and positioning of percutaneous drainage, which represent a minimally invasive, faster and more cost-effective alternative to open surgery procedures. This article will focus on the available state-of-the-art techniques to perform discovertebral image-guided biopsies in case of suspected infections and on image-guided placement of percutaneous drainage to treat infectious collections of the spine and paravertebral structures.
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Neuroimaging Clin. N. Am. · May 2015
ReviewOverview of the complications and sequelae in spinal infections.
Spondylitis or infection of the spine is a spectrum of diseases involving the bone, disks, and/or ligaments. Because of a significant increase in the immunocompromised patient population, spinal infections are a growing and changing group of conditions, making the diagnosis based on imaging more challenging. ⋯ This article provides a pictorial overview of the complications and sequelae in spinal infections in general. Discussed are postoperative infections, extraspinal spread of infection, fractures and malformations, and neurologic complications.
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Spinal involvement in human brucellosis is a common condition and a significant cause of morbidity and mortality, particularly in endemic areas, because it is often associated with therapeutic failure. Most chronic brucellosis cases are the result of inadequate treatment of the initial episode. ⋯ Early diagnosis is important to ensure proper treatment and decrease morbidity and mortality. Radiologic evaluation has gained importance in diagnosis and treatment planning, including interventional procedures and monitoring of all spinal infections.