ROLE OF MAGNETIC RESONANANCE IMAGING IN TUBERCULOUS SPONDYLITIS AND NEUROLOGICAL STATUS

Vinita Malhotra, Chandan Kumar, Raj Laxmi, A. K. Gupta, Ashok Kumar Verma

Abstract


INTRODUCTION: Tubercular spondylitis is de􀃶ned as an infection by Mycobacterium tuberculosis of one or more
of the extradural components of the spine namely the vertebra, intervertebral disks, paraspinal soft tissues and
epidural space. It is associated with disproportionate amount of morbidity due to its tendency to produce signi􀃶cant deformity and
neurologic complications. Therefore, Prompt diagnosis and treatment are of utmost importance. MRI has proven best technique for early
diagnosis tubercular spondylitis and neurological complications.
AIMS AND OBJECTIVES: MRI is a non-invasive diagnostic tool for evaluation and early diagnosis of tubercular spondylitis. To obtain the
correlation between MR imaging 􀃶ndings and the neurological status of the patient.
MATERIAL AND METHODS: 55 Patients with strong clinical suspicion of tubercular spondylitis with and without neurological de􀃶cit are
included. Proper history, clinical examination and neurological examination of affected cord followed by MRI study was done on 1.5 tesla
scanner.
RESULTS AND CONCLUSION: Early visualization of change in bone marrow intensity, erosion of end plate, destruction/ collapse of
vertebral body, loss of disc space and change in intensity of intervertebral disc space, pre and paravertebral soft tissue abscess/collection,
calci􀃶cation/ bony fragments in pre and paravertebral spaces, bilateral psoas abscess are well seen on MRI sequences. Epidural abscess,
thecal sac compression, CSF compression, cord edema, cord compression of spinal cord are also well seen on MRI. There is signi􀃶cant
correlation between the clinical as per the ASIA class and the MRI 􀃶ndings in relation to the spinal canal .IN MRI proper coil and proper
sequences were used.


Keywords


Magnetic Resonance Imaging, Spinal Tuberculosis, Neurological Complications.

Full Text:

PDF

References


Weaver P, Lifeso RM. The radiological diagnosis of tuberculosis of the adult spine, Skeletal Radiol 1984; 12(3): 178-186.

ModicMT,Feiglin DH, Piralno DW, Boumphery F. Weinstein MA Duchesneau PM et at: Vertebral Osteomyelitis: Assessment using MR Radiology. 1985;158: 157-166.

Lifeso RM, Weaver P. Harder, EH. Tuberculous spondylitis in adults, J Bone Joint Surg. Dec. 1985; 67-A (9): 1405-1413

Sharif HS, Clark DC. Aabed MY, Haddad MC. Al-Deeb SM, Yaqub B et al. Granulomatous spinal infections: MR imaging Radiology 1990: 177:101-107.

Boxer Dl. Pratt L. Hine AL, McNicol M: Radiological features during and following treatment of spinal tuberculosis. Br. J Radiol.1992; 65%476-479.

Name-Hyun Kim, Hwan – Mo Lee, Jin-Suck Sub. Magnetic Reasonance imaging for the diagnosis of tubercular spondylitis. Spine 1994; 19 (21): 2451-2455.

Shanley DJ: Tuberculosis of the Spine. Imaging Features AJR AM J Roentgenol 1995; 164: 659-664.

Sternbach G. Percival Pott: Tuberculous spondylities. J Emerg Med 1996; 14(1): 79-83.

Cotton A, Flipo RM. Drouot MH, Maury F, Chastanet P: Spinal Tuberculosis: Study of clinical and radiological aspect s from a series of 82 cases. J. Radiol 1996; 77(6) :419-426.

Gupta R.K. Agarwal P. Rastogi H, Kumar S. PhadkeRV: Problems in distinguishing spinal tuberculosis from neoplasis on MRI Neuroradiology. 1996; 38(1): 97-104.

Sharma A, Goyal M, Mishra NK Gupta, Y. Gaikwad SB. MR. Imaging of tuberculous spinal arachnoiditis. AJR Am J Roentgenol1997; 168(3) 807-812.

Moon MS. Tuberculosis of the spine Contoversies and a new challenge Spone.1997; 22(15):1791-1797.

Pertuiset E, Beaudreuil J, Liote F, et al. Spinal tuberculosis in adults. A study of 103 cases in a developed country, 1980-1994. Medicine (Baltimore), 1999; 78 (5): 309-320.

Turgut M. Spinal tuberculosis (Pott’s disease): its clinical presentation, Surgical management, and outcome. A survey study on 694 patients. Neurosurg Rev. 2001; 24(1): 8-13.

Moorthy S, Prabhu NK Spectrum of MR imaging findings in spinal tuberculosis.AJR Am J Roentgenol. 2002; 179(4): 979-983.

Jung NY, Jee WH, Ha KY et al. Discrimination of tuberculous spondylitis from pyogenic spondylitis on MRI. AJR Am J Roentgenol 2004: 182(6) 1405-1410

Rajasekaran S, Prasad Shetty A, Dheenadhayalan J, et al. Morphological changes during growth in healed childhood spinal tuberculosis: a 15- year prospective study of 61 children treated with ambulatory chemotherapy. J PediatrOrthop. 2006: 26(6): 716-724.


Refbacks

  • There are currently no refbacks.