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Cervical epidural spinal infection: MR imaging characteristics
1Department of Radiology, Jefferson Medical College, Philadelphia, PA.
AJR. American Journal of Roentgenology
|September 1, 1994
Summary
Cervical epidural spinal infection is aggressive, often involving multiple levels and causing abscesses. Prompt diagnosis via MR imaging is crucial due to frequent spinal cord compromise.
Area of Science:
- Radiology
- Neurology
- Infectious Diseases
Background:
- Cervical epidural spinal infection (diskitis, osteomyelitis, epidural space infection) is uncommon.
- MR imaging features are not fully described, especially in pyogenic cases.
Purpose of the Study:
- To determine MR imaging findings in cervical epidural spinal infections.
- Emphasis on pyogenic infections.
Main Methods:
- Retrospective review of 12,695 spinal MR examinations over 5.5 years.
- Identified 19 patients with cervical epidural spinal infection (18 pyogenic).
- MR imaging analyzed for osseous abnormalities, epidural inflammation, abscess, and cord compromise.
Main Results:
- Average of 3 vertebral bodies with abnormal bone marrow signal.
- Epidural inflammation averaged 4 levels, predominantly anterior.
- 50% of contrast-enhanced studies showed large epidural abscesses.
- Lower cervical segments (C5-C6) most affected.
- Spinal cord compression in 74%, hyperintensity in 63%.
Conclusions:
- Cervical epidural spinal infection is aggressive with multilevel, anterior involvement and frequent abscesses.
- Isolated epidural space infection without osseous abnormality is rare.
- Strong association with spinal cord compromise necessitates prompt diagnosis and treatment.