Needle aspiration/biopsy of the spine in suspected disc space infection

Armstrong, P.; Chalmers, A H; Green, G; Irving, J. D.

doi:10.1259/0007-1285-51-605-333

Cited by 47 publications

(14 citation statements)

References 9 publications

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“…Our yield of microbial organisms from the cases suspected of acute or chronic infection was disappointingly low (35%). However, this is in keeping with other reports; for example, both Armstrong and colleagues [9] and Murphy and colleagues [10] isolated organisms in only 58% of cases thought to have infective lesions. Possible reasons for this generally low yield of organisms include previous antimicrobial therapy, delicacy and scarcity of the organisms, faulty culture, and sampling error.…”

Section: Discussionsupporting

confidence: 89%

Radiologically Guided Bone Biopsy: Results of 502 Biopsies

Salisbury

Darby

et al. 1998

Cardiovasc Intervent Radiol

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Bone biopsy is a valuable technique for positive diagnosis of malignancy or infection, as it enables a definitive plan for treatment and management of patients to be established. Exclusion of serious pathology is almost equally important. In principle, any osseous site can be biopsied using fluoroscopic or computed tomographic guidance. Care in the biopsy technique and selection of the bone needle is required.

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Section: Discussionsupporting

confidence: 89%

Radiologically Guided Bone Biopsy: Results of 502 Biopsies

Salisbury

Darby

et al. 1998

Cardiovasc Intervent Radiol

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“…[56] However, rates of isolating the causative organism are less than 50% in TB spondylitis and 60 to 80% for pyogenic spondylitis. [23345758596061] In our series ( n = 16 of 26) cultures were negative for the growth of Mycobacterium tuberculosis probably because all were already on ATT prior to sending the culture. The patients in the TB group were treated based on HPE showing granulomatous inflammation with caseation.…”

Section: Discussionmentioning

confidence: 67%

Novel magnetic resonance imaging scoring system for diagnosis of spinal tuberculosis: A preliminary report

Chandrasekhar

Alugolu

Purohit

et al. 2013

Journal of Neurosciences in Rural Practice

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Background:There exists a lot of ambiguity in the preoperative diagnosis of the various vertebral lesions. Mostly in these patients tuberculosis of spine (TB) is suspected due to endemicity of the disease in the Indian subcontinent. However, no definite guidelines are available to diagnose tuberculous (TB) vertebral lesions in the current literature.Study Design:This prospective study was conducted in the Department of Neurosurgery, Nizam's Institute of Medical Sciences, from August 2009 to March 2012.Aim of the Study:To formulate non invasive methods to diagnose tuberculous vertebral lesions confidently so that the dependency on histopathologic diagnosis can be reduced.Material and Methods:Spinal MRI images of 45 patients suspected of having tuberculosis aetiology were included in the study prospectively.Results:A total of 64 patients were analysed and 19 patients were excluded due to lack of regular follow up or histological proof. The patients were divided into two groups; those with TB of the spine and those with some other condition affecting the spine (non TB spine) based on the final diagnosis. Of the 45 patients males were 30 (66.6%) and females were 15 (33.3%). There was no significant difference in the mean age of presentation. For TB patients this was 41 ± 15.56 years and in Non TB was 43 ± 18.27 years. All patients presented with backache in either group. There was epiphyseal involvement (100%), disc height reduction (71.42%) and pedicle destruction (42.82%) in plain X-rays in the TB group. Lumbar spine was the most common affected region in our study (26.31% in non TB and 34.6% in TB group of patients). Significant P value and the Odds Ratio was found for T1 hypo intensity, T2 hyper intensity, epiphyseal involvement, disc involvement, pedicle involvement, anterior subligamentous extension, paraspinal extension and no spinous process involvement (eight parameters). The eight parameters were tested among both the groups and it was noted that scores ≥ 6 favored a tuberculous pathology whereas ≤4 were suggestive of non tuberculous etiology.Conclusions:The eight point MRI criteria of the vertebral lesions are likely to enhance the diagnostic ability of tuberculous and non tuberculous pathologies thereby reducing the dependency on histopathologic diagnosis or invasive method for early initiation of therapy.

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“…Percutaneous bone biopsy is generally regarded as a safe technique, giving an accurate diagnosis of bone pathology [1,6]. Diagnostic accuracy is improved when larger cores are obtained, permitting both structural as well as cyto- logical information [4].…”

Section: Discussionmentioning

confidence: 99%

“…These complications include nerve or spinal cord damage, sinus formation, soft tissue recurrence of tumour, infection, pneumothorax, pneumonia and death [1,5,8]. Haemorrhagic complications following vertebral biopsy are rare, and out of a large study of 1061 cases there was only one case of haemorrhage in a patient with generalised plasmacytoma, where a haematoma was produced in the needle tract of the vertebral puncture [6].…”

Section: Discussionmentioning

confidence: 99%