• Sarah C Foreman, Benedikt J Schwaiger, Bernhard Meyer, Alexandra S Gersing, Claus Zimmer, Jens Gempt, and Jan S Kirschke.
• Department of Neuroradiology, Technische Universität München, Munich, Germany. Electronic address: Scforeman@hotmail.com.
• World Neurosurg. 2017 Aug 1; 104: 919-926.e2.

BackgroundPrognostic factors for the disease course of patients with spondylodiscitis have not been well studied.MethodsThe 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.ResultsOverall 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).ConclusionsCompared 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.Copyright © 2017 Elsevier Inc. All rights reserved.

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