Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · May 2015
ReviewOverview of the complications and sequelae in spinal infections.
Spondylitis or infection of the spine is a spectrum of diseases involving the bone, disks, and/or ligaments. Because of a significant increase in the immunocompromised patient population, spinal infections are a growing and changing group of conditions, making the diagnosis based on imaging more challenging. ⋯ This article provides a pictorial overview of the complications and sequelae in spinal infections in general. Discussed are postoperative infections, extraspinal spread of infection, fractures and malformations, and neurologic complications.
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This article summarizes myelopathy and radiculopathy caused by different viruses. The cases described are divided into three categories: acute myelitis and radiculitis, postinfectious myelopathy and radiculopathy, and chronic myelopathy. ⋯ Magnetic resonance (MR) imaging is an essential tool in diagnosis. However, because imaging findings are often nonspecific, consideration of a combination of diagnostic procedures, including the clinical course, symptoms, and laboratory data, is necessary for making a correct diagnosis.
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Spinal infections are a spectrum of disease comprising spondylitis, diskitis, spondylodiskitis, pyogenic facet arthropathy, epidural infections, meningitis, polyradiculopathy, and myelitis. Inflammation can be caused by pyogenic, granulomatous, autoimmune, idiopathic, and iatrogenic conditions. ⋯ Despite advanced diagnostic technology, diagnosis of this entity and differentiation from degenerative disease, noninfective inflammatory lesions, and spinal neoplasms are difficult. Radiological evaluations play an important role, with contrast-enhanced MR imaging the modality of choice in diagnosis, evaluation, treatment planning, interventional treatment, and treatment monitoring of spinal infections.
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Spinal involvement in human brucellosis is a common condition and a significant cause of morbidity and mortality, particularly in endemic areas, because it is often associated with therapeutic failure. Most chronic brucellosis cases are the result of inadequate treatment of the initial episode. ⋯ Early diagnosis is important to ensure proper treatment and decrease morbidity and mortality. Radiologic evaluation has gained importance in diagnosis and treatment planning, including interventional procedures and monitoring of all spinal infections.
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Inflammatory and infectious disorders of the spine in children are less common than in adults, and are usually categorized according to location into (1) those predominantly affecting the spinal cord; (2) those predominantly affecting the nerve roots and meninges; and (3) those predominantly affecting the vertebrae, discs, and epidural space. Disorders primitively involving the spinal cord may be grouped into 2 basic categories: (1) inflammatory (represented by acute transverse myelopathy) and (2) infectious (ie, bacterial, viral, fungal, or parasitic). Inflammatory spinal cord diseases are more common than primitive spinal cord infection.