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In Vivo Mouse Model of Spinal Implant Infection
Published on: June 23, 2020
An Imaging-Based Approach to Spinal Cord Infection
Jason F Talbott1, Jared Narvid2, J Levi Chazen3
1Department of Radiology, San Francisco General Hospital, San Francisco, CA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA.
Abstract:
Infections of the spinal cord, nerve roots, and surrounding meninges are uncommon, but highly significant given their potential for severe morbidity and even mortality. Prompt diagnosis can be lifesaving, as many spinal infections are treatable. Advances in imaging technology have now firmly established magnetic resonance imaging (MRI) as the gold standard for spinal cord imaging evaluation, enabling the depiction of infectious myelopathies with exquisite detail and contrast. In this article, we aim to provide an overview of MRI findings for spinal cord infections with special focus on imaging patterns of infection that are primarily confined to the spinal cord, spinal meninges, and spinal nerve roots. In this context, we describe and organize this review around 5 distinct patterns of transverse spinal abnormality that may be detected with MRI as follows: (1) extramedullary, (2) centromedullary, (3) eccentric, (4) frontal horn, and (5) irregular. We seek to classify the most common presentations for a wide variety of infectious agents within this image-based framework while realizing that significant overlap and variation exists, including some infections that remain occult with conventional imaging techniques.
Insights
Prompt diagnosis of spinal infections is crucial. Magnetic resonance imaging (MRI) reveals distinct patterns of spinal cord, meninges, and nerve root infections, aiding in early detection and treatment.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Spinal infections, though uncommon, pose significant risks of severe morbidity and mortality.
- Early diagnosis is critical for effective treatment and improved patient outcomes.
- Magnetic resonance imaging (MRI) is the gold standard for evaluating spinal cord pathology.
Purpose of the Study:
- To provide an overview of MRI findings in spinal cord infections.
- To focus on imaging patterns of infections affecting the spinal cord, meninges, and nerve roots.
- To classify common infectious presentations based on MRI-detected transverse spinal abnormalities.
Main Methods:
- Review of MRI findings in spinal infections.
- Classification of abnormalities into five distinct patterns: extramedullary, centromedullary, eccentric, frontal horn, and irregular.
- Correlation of imaging patterns with various infectious agents.
Main Results:
- MRI enables detailed visualization of spinal cord infections.
- Five distinct MRI patterns of transverse spinal abnormality are identified.
- These patterns help classify common infectious agents, though overlap and occult infections exist.
Conclusions:
- MRI is essential for diagnosing spinal infections.
- Recognizing specific MRI patterns aids in identifying the causative infectious agents.
- Advanced imaging improves the detection and management of these serious conditions.
