Spinal tuberculosis: CT and MRI features

Abstract

BACKGROUNDSpinal tuberculosis (TB) is perhaps the most clinically important extrapulmonary form of the disease. Early recognition is therefore necessary to minimize residual spinal deformity and/or permanent neurological deficit. We defined the CT and MRI image morphology of spinal TB and correlated the imaging features of these two modalities.METHODSCT (29 patients) and MRI (11 patients) images were retrospectively analyzed in 30 patients with proved spinal TB. CT and MRI findings were compared in cases with both imaging tests (10 cases). The parameters assessed were the type and extent of bone and soft tissue involvement.RESULTSThe majority of the 30 patients were males (n=18) in the 30–49 year age group (43%). The most common clinical presentation was backache (73.3%) followed by fever (63.3%) and malaise (36.6%). The lumbar spine was the commonest site of the disease (43.3%) followed by the thoracic region (36.6%). A fragmentary type of bone destruction was the most frequent CT feature of the disease (48.2%) followed by the lytic type (24.1%). Intervertebral disc destruction (72%) and paravertebral mass/abscess (65.5%) were other features. Of the 11 patients who had an MRI, contiguous vertebral disease with disc destruction was seen in 10 cases. In 4 patients, there was distant vertebral disease in addition to the disease at the symptomatic site.CONCLUSIONSMRI offers excellent visualization of the bone and soft tissue components of spinal tuberculosis and helps to identify disease at distant asymptomatic sites. CT is useful in assessing bone destruction, but is less accurate in defining the epidural extension of the disease and therefore its effect on neural structures. MR imaging clearly demonstrated the extent of soft tissue disease and its effect on the theca/cord and foramen in cases with doubtful CT findings.

Pott’s Spine: Retrospective Analysis of MRI Scans of 70 Cases

“…This suggested that in the economically productive years of life, Pott's spine was more prevalent in females. The lower thoracic and the upper lumbar levels were found to be most commonly affected in most of the studies [1,2,8,10]. In our study, the lumbar vertebrae were most commonly affected, followed by the dorsal vertebrae, which was similar to the findings of Sinan et al [8].…”

“…In our study, most of the cases were between the ages of 21-50 years (mean 38.3 + 17.6), which was similar to the finding of Mirsaeidi et al, [9] who found a mean age of 39 + 16 years. Tuberculosis of the spine was found to be more common in males than in females in most of the previously published series [4,[8][9][10], although Osborn [7] suggested no gender predilection. We noted that although overall Pott's spine was more prevalent in males, in between 21-50 years of age in which Pott's spine was the most prevalent, there was a female predominance (55%).…”

“…Osborn [7] stated that in the developing countries it was prevalent in the younger age group, while in the western world, it was found in the middle age (mean 40-45 years). Sinan et al, [8] found 43% cases in their study in the age group of 30-49 years. In our study, most of the cases were between the ages of 21-50 years (mean 38.3 + 17.6), which was similar to the finding of Mirsaeidi et al, [9] who found a mean age of 39 + 16 years.…”

“…The lower thoracic and the upper lumbar levels were found to be most commonly affected in most of the studies [1,2,8,10]. In our study, the lumbar vertebrae were most commonly affected, followed by the dorsal vertebrae, which was similar to the findings of Sinan et al [8]. The atypical patterns of the tuberculous involvement of the spine consisted of the infection of a single vertebra or of multiple nonadjacent vertebrae (skip lesions), which in our study were noted in 1.42% and 2.85% of the cases respectively.…”

Clinical Presentation of Pott?s disease of the Spine in Adult Sudanese Patients

“…The first and most common clinical symptom of Pott's disease is the back pain, followed with fever [13].…”