Spinal tuberculosis: atypical observations at MR imaging.

Ahmadi, Jamshid; Bajaj, Amishi; Destian, Sylvie; Segall, Hervey D.; Zee, Chi‐Shing

doi:10.1148/radiology.189.2.8210378

Cited by 110 publications

(70 citation statements)

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“…MRI scanning is extremely useful for assisting in the diagnosis and surgical planning, but is by no means diagnostic. Confusion, particularly with metastatic malignancy, is possible and a tissue diagnoses is still essential [1,8,9,16].…”

Section: Resultsmentioning

confidence: 99%

Noncontiguous spinal tuberculosis: incidence and management

2009

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Tuberculosis (TB) has a worthy reputation as one of the great mimickers in medicine with a multitude of clinical pictures and variations. Noncontiguous spinal TB is described as atypical and case reports are published as rarities in the mainstream academic journals. The aim of the study was to asses the incidence and review of the management of non-contiguous spinal TB. We identified 16 cases of noncontiguous spinal TB from a single surgeon series of 98 patients, who were managed surgically between 2001 and 2006. These were diagnosed on whole spine MRI. This represents the largest series reported in literature to date and is higher than the expected incidence. Case notes and imaging were retrospectively reviewed in an attempt to ascertain if there were any parameters to differentiate this group from the rest of the TB spine population. Our incidence of noncontiguous spinal TB is 16.3%. There was a higher incidence of neurology in the noncontiguous group (75%) compared to the rest of our group (58.5%). Non-contiguous TB was not found to be a manifestation of HIV, MDR TB or of chronicity in our series. Most noncontiguous lesions were evident on plain radiology. Noncontiguous spinal TB is common in areas of high prevalence such as South Africa. Despite being frequently missed initially, noncontiguous involvement is evident on plain radiography and simply requires a higher index of suspicion. When investigating spine TB patients, simple radiology of the entire spine is mandatory. If available, a full spine sagittal MRI is extremely useful in identifying noncontiguous lesions. Treatment of noncontiguous tuberculosis is as for standard spinal TB cases in our unit with similar outcomes, but care needs to be taken in surgical planning as patients may have multiple areas of neurological compromise.

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Section: Resultsmentioning

confidence: 99%

Noncontiguous spinal tuberculosis: incidence and management

2009

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“…24 Microbiological diagnosis is virtually impossible without aspiration of pus or some form of tissue sampling, as few patients have concomitant renal or pulmonary disease yielding diagnostic urine or sputum. However, collection of a spinal or paraspinal specimen is not absolutely necessary if pulmonary or lymph node TB is present or if extraskeletal sites can be sampled.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis of the spine (Pott's disease) presenting as ‘compression fractures’

2002

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“…10 The best noninvasive diagnostic modality for spinal tuberculosis is MRI. 8,11 MRI is more sensitive than radiography and more specific than CT in the diagnosis of spinal tuberculosis. The anatomical pattern revealed by MRI, particularly the soft tissue and disc involvement, yields greater specificity.…”

Section: Discussionmentioning

confidence: 99%

Results of management of spinal tuberculosis according to middle path regime and short course chemotheraphy

Jagiasi

Patel

2017

Int J Res Orthop

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Background: Vertebral tuberculosis is the most common form of skeletal tuberculosis and it contributes about 50 percent of all cases of skeletal tuberculosis. The purpose of this study is to delineate the importance of middle path regime and short course chemotheraphy in the management of spine tuberculosis.Methods: A prospective study was conducted which included 44 patients diagnosed as tuberculous spondylitis. Management was started as per middle path regime and drugs were given as per the revised national tuberculosis control program (RNTCP) regime category I under directly observed treatment, short-course (DOTS) therapy. Specimen was collected and studied for smear, culture, antibiotic sensitivity and histopathology. ATT was stopped at the end of 6 months as per DOTS schedule and MRI was done at the end of therapy.Results: Dorsal spine lesions were found in 33 patients. 8 patients were smear positive and 38 patients were culture positive of whom 26 patients were sensitive to first line ATT drugs. 12 patients had MDR tuberculosis and were sensitive to 2nd line ATT drugs. 6 patients having negative culture were diagnosed from histopathology. All patients on 1st line ATT had satisfactory result. Only 8 patients with MDR tuberculosis recovered neurologically. Conclusions: It is mandatory to do obtain tissue biopsy and examine culture, sensitivity and histopathology. Recently there is an increasing tendency in multidrug resistance cases and total drug resistant cases. By doing culture and sensitivity of the specimen we can find out the number of MDR cases and initiate proper drug regimen to avoid further complication and mortality.

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Spinal tuberculosis: atypical observations at MR imaging.

Abstract: Neither clinical examination nor MR findings may be reliable in helping differentiate spinal infections from one another or from neoplasm. Adequate biopsy is essential for early diagnosis and prompt treatment.

Cited by 110 publications

References 0 publications

Noncontiguous spinal tuberculosis: incidence and management

Noncontiguous spinal tuberculosis: incidence and management

Tuberculosis of the spine (Pott's disease) presenting as ‘compression fractures’

Results of management of spinal tuberculosis according to middle path regime and short course chemotheraphy

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