Abstract
Background: Prognostic factors for the disease course of patients with spondylodiscitis have not been well studied. Methods: The prognostic value of initial magnetic resonance imaging (MRI) and computed tomography imaging parameters was analyzed in 62 patients (47% women; mean age ± SD, 71.6 ± 9.6 years) with a confirmed diagnosis of spondylodiscitis. The disease course was separately evaluated during initial treatment response during hospitalization, relapse, and clinical short-term follow-up at 3 months. Results: Overall CT findings graded as definitely inflammatory (P = 0.006), reduced disc height on MRI (P = 0.044) and fluid-equivalent hyperintensity of discs on T2 short tau inversion recovery–weighted sequences (P = 0.047) were associated with poor initial treatment response. High initial C-reactive protein value (>10.1 mg/dL) was associated with a higher relapse rate (P = 0.038). Risk factors for poor outcome were infection with low-virulence bacteria (P = 0.040) and overall MRI findings atypical for infection (P = 0.027). Conclusions: Compared with MRI, CT imaging parameters have a higher prognostic value regarding the disease course. Patients infected with low-virulence bacteria and atypical MRI findings are at higher risk for poor clinical outcome and thus warrant closer monitoring.
Original language | English |
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Pages (from-to) | 919-926.e2 |
Journal | World Neurosurgery |
Volume | 104 |
DOIs | |
State | Published - Aug 2017 |
Keywords
- CT
- Infection
- MRI
- Outcome
- Spine
- Spondylodiscitis