Radiologic clinics of North America
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This article reviews the imaging and relevant clinical details of infection of the extradural spine. Spine infections are increasing in incidence and in frequency of diagnosis. They are clinically important despite their relative rarity, because they may be life-threatening, and because early diagnosis leads to improved outcomes. ⋯ Nonpyogenic, granulomatous infections are also addressed. Magnetic resonance imaging is emphasized. The radiologist's role in performing minimally invasive sampling procedures is highlighted.
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Imaging assessment of the postoperative spine is complex and depends on many factors. Postoperative imaging studies evaluate the position of implants, adequacy of decompression, fusion status, and potential complications. This article provides a review of various imaging techniques, with their advantages and disadvantages, for the evaluation of the postoperative spine. It also gives an overview of normal and abnormal postoperative appearances of the spine as seen via various modalities, with an emphasis on postoperative complications.
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Radiol. Clin. North Am. · Jul 2012
ReviewLumbar diskogenic pain, provocation diskography, and imaging correlates.
Diskogenic pain refers to pain mediated by the intrinsic innervation of the intervertebral disk. It is experienced as pain centered at the symptomatic spine segment (axial pain) without radicular features or radiculopathy. ⋯ This article reviews diskogenic pain, the history of provocation diskography, and its current use in the diagnosis of lumbar diskogenic pain. The extensive literature describing imaging features which may predict a positive diskogram, and allow non-invasive diagnosis of diskogenic pain, is examined.
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Although most often back pain is of benign origin, it can occasionally be a harbinger of a more serious spinal condition, including spine neoplasm. Knowledge of the typical clinical history of spinal tumors and an understanding of the innervation of the spine and surrounding supporting structures may allow us to better understand when to pursue advanced imaging in the evaluation of spinal pain syndromes. Many radiologists have divided the differential diagnosis of neoplasms of the spine into compartments. These compartments include the extradural compartment, intradural/extramedullary compartment, and the intramedullary compartment.
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Spinal dural arterial venous fistulas (SDAVFs) are the most common vascular malformation of the spine. They typically present in elderly men with slowly progressive myelopathic symptoms. ⋯ Radiologists should be familiar with the imaging features of this entity, with the surgical and angiographic interventions, and with the expected postprocedural radiographic appearance. This article reviews spinal vascular anatomy, the radiographic appearances of SDAVF, techniques for finding the SDAVF, clinical presentations, treatment options, and postprocedural radiographic appearances of the spinal cord.