Imaging in spinal infections: Current status and future directions

Area of Science:

• Radiology and Medical Imaging
• Infectious Diseases
• Orthopedics

Background:

• Spinal infections require prompt diagnosis for effective treatment and improved patient outcomes.
• Various imaging modalities are utilized, each with specific strengths in visualizing spinal pathologies.

Purpose of the Study:

• To review the imaging characteristics and clinical aspects of common spinal infections.
• To highlight the role of advanced imaging in the early and accurate diagnosis of spinal infections.

Main Methods:

• Review of imaging findings for pyogenic spondylodiscitis, tuberculous spondylodiscitis, septic facet arthritis, epidural abscess, and subdural abscess.
• Emphasis on Magnetic Resonance Imaging (MRI) as the primary advanced imaging modality.
• Discussion of the utility of Computed Tomography (CT) and nuclear medicine imaging when MRI is contraindicated or unavailable.

Main Results:

• Radiographs may show subtle changes, but advanced imaging significantly increases diagnostic sensitivity.
• MRI is generally the most sensitive and specific modality for diagnosing spinal infections.
• CT and nuclear medicine imaging are valuable alternatives and adjuncts to MRI.

Conclusions:

• Advanced imaging, especially MRI, is essential for the early diagnosis of spinal infections.
• CT imaging is crucial for guiding biopsies for targeted antimicrobial therapy.
• A comprehensive understanding of imaging findings aids in timely and effective management of spinal infections.