Sarah C Foreman1, Benedikt J Schwaiger2, Bernhard Meyer3, Alexandra S Gersing2, Claus Zimmer4, Jens Gempt3, Jan S Kirschke4. 1. Department of Neuroradiology, Technische Universität München, Munich, Germany. Electronic address: Scforeman@hotmail.com. 2. Department of Radiology, Technische Universität München, Munich, Germany. 3. Department of Neurosurgery, Technische Universität München, Munich, Germany. 4. Department of Neuroradiology, Technische Universität München, Munich, Germany.
Abstract
BACKGROUND: Prognostic factors for the disease course of patients with spondylodiscitis have not been well studied. METHODS: The prognostic value of initial magnetic resonance imaging (MRI) and computed tomography imaging parameters was analyzed in 62 patients (47% women; mean age ± SD, 71.6 ± 9.6 years) with a confirmed diagnosis of spondylodiscitis. The disease course was separately evaluated during initial treatment response during hospitalization, relapse, and clinical short-term follow-up at 3 months. RESULTS: Overall CT findings graded as definitely inflammatory (P = 0.006), reduced disc height on MRI (P = 0.044) and fluid-equivalent hyperintensity of discs on T2 short tau inversion recovery-weighted sequences (P = 0.047) were associated with poor initial treatment response. High initial C-reactive protein value (>10.1 mg/dL) was associated with a higher relapse rate (P = 0.038). Risk factors for poor outcome were infection with low-virulence bacteria (P = 0.040) and overall MRI findings atypical for infection (P = 0.027). CONCLUSIONS: Compared with MRI, CT imaging parameters have a higher prognostic value regarding the disease course. Patients infected with low-virulence bacteria and atypical MRI findings are at higher risk for poor clinical outcome and thus warrant closer monitoring.
BACKGROUND: Prognostic factors for the disease course of patients with spondylodiscitis have not been well studied. METHODS: The prognostic value of initial magnetic resonance imaging (MRI) and computed tomography imaging parameters was analyzed in 62 patients (47% women; mean age ± SD, 71.6 ± 9.6 years) with a confirmed diagnosis of spondylodiscitis. The disease course was separately evaluated during initial treatment response during hospitalization, relapse, and clinical short-term follow-up at 3 months. RESULTS: Overall CT findings graded as definitely inflammatory (P = 0.006), reduced disc height on MRI (P = 0.044) and fluid-equivalent hyperintensity of discs on T2 short tau inversion recovery-weighted sequences (P = 0.047) were associated with poor initial treatment response. High initial C-reactive protein value (>10.1 mg/dL) was associated with a higher relapse rate (P = 0.038). Risk factors for poor outcome were infection with low-virulence bacteria (P = 0.040) and overall MRI findings atypical for infection (P = 0.027). CONCLUSIONS: Compared with MRI, CT imaging parameters have a higher prognostic value regarding the disease course. Patients infected with low-virulence bacteria and atypical MRI findings are at higher risk for poor clinical outcome and thus warrant closer monitoring.
Authors: Pierpaolo Palumbo; Federico Bruno; Francesco Arrigoni; Marcello Zappia; Anna Maria Ierardi; Giuseppe Guglielmi; Luigi Zugaro; Marina Carotti; Ernesto Di Cesare; Alessandra Splendiani; Luca Brunese; Carlo Masciocchi; Antonio Barile Journal: Acta Biomed Date: 2020-07-13