CT in the evaluation of spine infection

Little experience of computed tomography (CT) evaluation of spinal infection has been reported. We collected 20 patients with spinal infection studied with CT. Fifteen patients had pyogenic infections, four had tubercular lesions, and one infection was fungal. Predisposing factors for spinal infection were present in ten of 20 patients. Metrizamide was injected into the subarachnoid space prior to CT in nine of 20 patients. CT detected bony destruction in all patients with osseous involvement. In addition, CT diagnosed prevertebral abscess formation and/or extension of the process into the spinal canal (and its level) in 12 of 15 patients with pyogenic infection in these sites. All tubercular infections showed prevertebral soft tissue involvement, one was associated with an epidural block. In our experience, CT can combine information provided by conventional tomography and myelography in one imaging modality, and offers the unique ability to provide direct evidence of spread of infection into the soft tissues.