Seminars in Spine Surgery
Volume 19, Issue 2 , Pages 106-112 , June 2007

The Imaging of Spinal Infections

  • Jonathan R. Stieber, MD

      Affiliations

    • Division of Spine Surgery, Hospital for Joint Diseases-New York University, New York, NY.
    • ,
  • Mark E. Schweitzer, MD

      Affiliations

    • Department of Radiology, Hospital for Joint Diseases-New York University, New York, NY.
    • Department of Orthopaedic Surgery, Hospital for Joint Diseases-New York University, New York, NY.
    • ,
  • Thomas J. Errico, MD

      Affiliations

    • Division of Spine Surgery, Hospital for Joint Diseases-New York University, New York, NY.
    • Department of Orthopaedic Surgery, Hospital for Joint Diseases-New York University, New York, NY.
    • Corresponding Author InformationAddress reprint requests to Thomas J. Errico, MD, Chief, Division of Spine Surgery, Department of Orthopaedic Surgery, Hospital for Joint Diseases-New York University, Associate Professor of Orthopaedic Surgery and Neurosurgery, New York University School of Medicine, 530 First Avenue, Suite 8U, New York, NY 10016.

References 

  1. Massie JB, Heller JG, Abitbol JJ, McPherson D, Garfin SR. Postoperative posterior spinal wound infections. Clin Orthop Relat Res. 1992;99–108
  2. Lindholm TS, Pylkkanen P. Discitis following removal of intervertebral disc. Spine. 1982;7:618–622
  3. Schulitz KP, Assheuer J. Discitis after procedures on the intervertebral disc. Spine. 1994;19:1172–1177
  4. Horwitz NH, Curtin JA. Prophylactic antibiotics and wound infections following laminectomy for lumber disc herniation. J Neurosurg. 1975;43:727–731
  5. Herkowitz HN, Rothman RH, Simeone FA. In: Rothman-Simeone, The Spine. vol. 2:Philadelphia: Saunders Elsevier; 2006;
  6. Levi AD, Dickman CA, Sonntag VK. Management of postoperative infections after spinal instrumentation. J Neurosurg. 1997;86:975–980
  7. Cruse PJ, Foord R. The epidemiology of wound infection (A 10-year prospective study of 62,939 wounds). Surg Clin North Am. 1980;60:27–40
  8. Fang D, Cheung KM, Dos Remedios ID, et al. Pyogenic vertebral osteomyelitis: treatment by anterior spinal debridement and fusion. J Spinal Disord. 1994;7:173–180
  9. Sapico FL, Montgomerie JZ. Pyogenic vertebral osteomyelitis: report of nine cases and review of the literature. Rev Infect Dis. 1979;1:754–776
  10. Bonakdar-pour A, Gaines VD. The radiology of osteomyelitis. Orthop Clin North Am. 1983;14:21–37
  11. An HS, Seldomridge JA. Spinal infections: diagnostic tests and imaging studies. Clin Orthop Relat Res. 2006;444:27–33
  12. James SL, Davies AM. Imaging of infectious spinal disorders in children and adults. Eur J Radiol. 2006;58:27–40
  13. Modic MT, Feiglin DH, Piraino DW, et al. Vertebral osteomyelitis: assessment using MR. Radiology. 1985;157:157–166
  14. Varma R, Lander P, Assaf A. Imaging of pyogenic infectious spondylodiskitis. Radiol Clin North Am. 2001;39:203–213
  15. Ross PM, Fleming JL. Vertebral body osteomyelitis: spectrum and natural history (A retrospective analysis of 37 cases). Clin Orthop Relat Res. 1976;190–198
  16. Rothman SL. The diagnosis of infections of the spine by modern imaging techniques. Orthop Clin North Am. 1996;27:15–31
  17. Ousehal A, Gharbi A, Zamiati W, et al. [Imaging findings in 122 cases of Pott’s disease]. Neurochirurgie. 2002;48:409–418
  18. Stoker DJ, Kissin CM. Percutaneous vertebral biopsy: a review of 135 cases. Clin Radiol. 1985;36:569–577
  19. Silber JS, Anderson DG, Vaccaro AR, et al. Management of postprocedural discitis. Spine J. 2002;2:279–287
  20. Dagirmanjian A, Schils J, McHenry M, et al. MR imaging of vertebral osteomyelitis revisited. AJR Am J Roentgenol. 1996;167:1539–1543
  21. Tali ET. Spinal infections. Eur J Radiol. 2004;50:120–133
  22. Lang IM, Hughes DG, Jenkins JP, et al. MR imaging appearances of cervical epidural abscess. Clin Radiol. 1995;50:466–471
  23. Parkinson JF, Sekhon LH. Spinal epidural abscess: appearance on magnetic resonance imaging as a guide to surgical management (Report of five cases). Neurosurg Focus. 2004;17:E12
  24. Friedmand DP, Hills JR. Cervical epidural spinal infection: MR imaging characteristics. AJR Am J Roentgenol. 1994;163:699–704
  25. Joseffer SS, Cooper PR. Modern imaging of spinal tuberculosis. J Neurosurg Spine. 2005;2:145–150
  26. Jung NY, Jee WH, Ha KY, et al. Discrimination of tuberculous spondylitis from pyogenic spondylitis on MRI. AJR Am J Roentgenol. 2004;182:1405–1410
  27. De Vuyst D, Vanhoenacker F, Gielen J, et al. Imaging features of musculoskeletal tuberculosis. Eur Radiol. 2003;13:1809–1819
  28. Mellado JM, Perez del Palomar L, Camins A, et al. MR imaging of spinal infection: atypical features, interpretive pitfalls and potential mimickers. Eur Radiol. 2004;14:1980–1989
  29. Ledermann HP, Schweitzer ME, Morrison WB, et al. MR imaging findings in spinal infections: rules or myths?. Radiology. 2003;228:506–514
  30. Shih TT, Huang KM, Hou SM. Early diagnosis of single segment vertebral osteomyelitis—MR pattern and its characteristics. Clin Imaging. 1999;23:159–167
  31. Kayani I, Syed I, Saifuddin A, et al. Vertebral osteomyelitis without disc involvement. Clin Radiol. 2004;59:881–891
  32. Prandini N, Lazzeri E, Rossi B, et al. Nuclear medicine imaging of bone infections. Nucl Med Commun. 2006;27:633–644
  33. Schauwecker DS, Carlson KA, Miller GA, et al. Comparison of indium-111 nonspecific polyclonal IgG with indium-111-leukocytes in a canine osteomyelitis model. J Nucl Med. 1991;32:1394–1398
  34. Rodiek SO. [Diagnostic methods in spinal infections]. Radiologe. 2001;41:976–986
  35. Alazraki N, Dries D, Datz F, et al. Value of a 24-hour image (four-phase bone scan) in assessing osteomyelitis in patients with peripheral vascular disease. J Nucl Med. 1985;26:711–717
  36. Choong K, Monaghan P, McGuigan L, et al. Role of bone scintigraphy in the early diagnosis of discitis. Ann Rheum Dis. 1990;49:932–934
  37. Hoffer P. Gallium: mechanisms. J Nucl Med. 1980;21:282–285
  38. Bruschwein DA, Brown ML, McLeod RA. Gallium scintigraphy in the evaluation of disk-space infections: concise communication. J Nucl Med. 1980;21:925–927
  39. Gratz S, Dorner J, Oestmann JW, et al. 67Ga-citrate and 99Tcm-MDP for estimating the severity of vertebral osteomyelitis. Nucl Med Commun. 2000;21:111–120
  40. Whalen JL, Brown ML, McLeod R, et al. Limitations of indium leukocyte imaging for the diagnosis of spine infections. Spine. 1991;16:193–197
  41. Weinstein MA, Eismont FJ. Infections of the spine in patients with human immunodeficiency virus. J Bone Joint Surg Am. 2005;87:604–609
  42. Palestro CJ, Kim CK, Swyer AJ, et al. Radionuclide diagnosis of vertebral osteomyelitis: indium-111-leukocyte and technetium-99m-methylene diphosphonate bone scintigraphy. J Nucl Med. 1991;32:1861–1865
  43. Delbeke D. Oncological applications of FDG PET imaging. J Nucl Med. 1999;40:1706–1715
  44. Schmitz A, Risse JH, Grunwald F, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography findings in spondylodiscitis: preliminary results. Eur Spine J. 2001;10:534–539
  45. Vanninen E, Laitinen T, Partanen K, et al. Late correlative imaging findings of previous acute infective spondylitis. Clin Nucl Med. 2000;25:779–784
  46. De Winter F, Gemmel F, Van De Wiele C, et al. 18-Fluorine fluorodeoxyglucose positron emission tomography for the diagnosis of infection in the postoperative spine. Spine. 2003;28:1314–1319
  47. Gratz S, Dorner J, Fischer U, et al. 18F-FDG hybrid PET in patients with suspected spondylitis. Eur J Nucl Med Mol Imaging. 2002;29:516–524
  48. Guhlmann A, Brecht-Krauss D, Suger G, et al. Fluorine-18-FDG PET and technetium-99m antigranulocyte antibody scintigraphy in chronic osteomyelitis. J Nucl Med. 1998;39:2145–2152
  49. Kalicke T, Schmitz A, Risse JH, et al. Fluorine-18 fluorodeoxyglucose PET in infectious bone diseases: results of histologically confirmed cases. Eur J Nucl Med. 2000;27:524–528
  50. Meller J, Koster G, Liersch T, et al. Chronic bacterial osteomyelitis: prospective comparison of (18)F-FDG imaging with a dual-head coincidence camera and (111)In-labelled autologous leucocyte scintigraphy. Eur J Nucl Med Mol Imaging. 2002;29:53–60
  51. Van Acker F, Nuyts J, Maes A, et al. FDG-PET, 99mtc-HMPAO white blood cell SPET and bone scintigraphy in the evaluation of painful total knee arthroplasties. Eur J Nucl Med. 2001;28:1496–1504
  52. Zhuang HM, Cortes-Blanco A, Pourdehnad M, et al. Do high glucose levels have differential effect on FDG uptake in inflammatory and malignant disorders. Nucl Med Commun. 2001;22:1123–1128
  53. Stumpe KD, Zanetti M, Weishaupt D, et al. FDG positron emission tomography for differentiation of degenerative and infectious endplate abnormalities in the lumbar spine detected on MR imaging. AJR Am J Roentgenol. 2002;179:1151–1157
  54. De Winter F, Vogelaers D, Gemmel F, et al. Promising role of 18-F-fluoro-D-deoxyglucose positron emission tomography in clinical infectious diseases. Eur J Clin Microbiol Infect Dis. 2002;21:247–257
  55. Termaat MF, Raijmakers PG, Scholten HJ, et al. The accuracy of diagnostic imaging for the assessment of chronic osteomyelitis: a systematic review and meta-analysis. J Bone Joint Surg Am. 2005;87:2464–2471
  56. Lazzeri E, Pauwels EK, Erba PA, et al. Clinical feasibility of two-step streptavidin/111In-biotin scintigraphy in patients with suspected vertebral osteomyelitis. Eur J Nucl Med Mol Imaging. 2004;31:1505–1511
  57. Britton KE, Wareham DW, Das SS, et al. Imaging bacterial infection with (99m)Tc-ciprofloxacin (Infecton). J Clin Pathol. 2002;55:817–823
  58. De Winter F, Gemmel F, Van Laere K, et al. 99mTc-ciprofloxacin planar and tomographic imaging for the diagnosis of infection in the postoperative spine: experience in 48 patients. Eur J Nucl Med Mol Imaging. 2004;31:233–239

PII: S1040-7383(07)00036-6

doi: 10.1053/j.semss.2007.04.005

Seminars in Spine Surgery
Volume 19, Issue 2 , Pages 106-112 , June 2007

Article Tools

* Image Usage & Resolution